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Care-seeking of patients with multiple sclerosis over 2010-2015 in France: a nationwide study using health administrative data
Author(s): ,
J. Roux
Affiliations:
Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and Health Services Research) - EA 7449; INSERM CIC-P 1414, Rennes, France
,
A. Guilleux
Affiliations:
Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and Health Services Research) - EA 7449
,
O. Grimaud
Affiliations:
Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and Health Services Research) - EA 7449
E. Leray
Affiliations:
Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and Health Services Research) - EA 7449; INSERM CIC-P 1414, Rennes, France
ECTRIMS Online Library. Roux J. Oct 12, 2018; 228842; P1000
Jonathan Roux
Jonathan Roux
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Abstract: P1000

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Epidemiology

Introduction: There is currently a lack of data on the exact level of care-seeking of persons with multiple sclerosis (PwMS) in France.
Objective: To describe care-seeking of PwMS over the 2010-2015 period using the French health insurance system databases.
Methods: An exhaustive study population was formed of all prevalent and incident PwMS in the French national health insurance databases (97% of French general population covered). They were identified over 2010-2015 thanks to a validated algorithm using diagnoses of hospital admissions, MS-specific disease-modifying therapies (DMTs) and MS long disease duration status. Access to healthcare was considered over 2010-2015 period. Care consumptions of interest were: consultations with general practitioners (GPs), neurologists and several specialists of disability symptoms (physical medicine and rehabilitation physician, urologist, and ophthalmologist). In addition, hospital admissions related to MS in medicine, surgery or obstetrics (MSO), aftercare and rehabilitation and psychiatric centres and use of DMTs were also considered.
Results: In total, 112,605 PwMS were identified (sex-ratio F:M=2.4 and median age of 46 years in 2010). The median numbers of visits with GPs, neurologists, and specialists of disability symptoms were 5.5, 0.7, 0.3 visits per person-year, respectively. About a third of the population (32.1%) and a fifth (19.2%) had only a medical follow-up with private neurologists or in-hospital neurologists, respectively; while 23.1% of PwMS visited both types of neurologists over the 6-year period. A quarter of PwMS (25.6%) never accessed to neurologists. Regarding paramedical care, 5,451 (4.8%) and 12,843 (11.4%) PwMS had at least 15 acts per year with a nurse or a physiotherapist, respectively. Regarding hospital admissions related to MS, 52.4% of PwMS had at least one stay in MSO, 17.9% at least one admission in a rehabilitation centre and 0.1% at least one stay in a psychiatric centre over study period. Amongst PwMS, 47.5% received at least one DMT: 80.6% had at least one injectable DMT, 43.1% at least an oral one, and 15.5% at least one natalizumab infusion.
Conclusions: To our knowledge, this is the first study conducted on the whole population of PwMS in France over 2010-2015. This dataset offers the opportunity to study care practices for MS at national level, and is complementary to data collected in MS expert centres or in the OFSEP registry.
Disclosure: This work was supported by the French National Agency for Medicines and Health Products Safety (ANSM).
J. Roux was funded as PhD fellowship by the French National Agency for Medicines and Health Products Safety (ANSM) for this work.
A. Guilleux has nothing to disclose.
O. Grimaud has nothing to disclose.
E. Leray reports consulting, lecture fees or travel grants from Biogen, Genzyme, MedDay Pharmaceuticals, Merck, Novartis and Roche.

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