Even decades before they were diagnosed, people with multiple sclerosis (MS) had a greater need for medical care compared to people without MS, according to a new study supported by the National Multiple Sclerosis Society and MS Canada.
The study — Phenotyping Healthcare Use 2-3 Decades Before the First Multiple Sclerosis Demyelinating Event — was published June 12 by Wiley Online Library.
Authors of the study reported that decades before they were diagnosed, people with MS made more visits to physicians’ offices, emergency departments (ED), and hospitals compared to people without MS. The study included data from more than 35,000 people with MS and more than 136,007 without MS.
The study noted “consistently elevated yearly physician visit rate ratios” for mental health care and “ill-defined signs/symptoms” 28 years before patients’ MS was diagnosed. Up to 24 years before diagnosis, MS patients sought help for nervous system, musculoskeletal system, respiratory issues, and injuries. Up to 22 years before diagnosis, MS patients sought care for digestive system issues.
As patients got closer to being diagnosed with MS, their health-care use increased, peaking the year before diagnosis.
“Higher health-care use was evident for over two decades before the first demyelinating event,” the authors concluded. Mental-related, ill-defined signs/symptoms, and primary care visits were consistently elevated the longest (28 years pre-index), followed by nervous-system, musculoskeletal, injury, respiratory-related, and digestive-system (22–24 years pre-index). Health-related phenotypical differences appear early in the MS disease process.”
Unlike Parkinson’s disease, another neurodegenerative condition, MS was initially believed not to have a prodromal phase in which early symptoms presented, researchers added.
“However, recent studies have demonstrated higher rates of health-care use, including for psychiatric conditions, gastrointestinal diseases, fatigue, anemia and pain, in the five to 10 years before MS onset compared to a matched population,” the authors added. “We accessed and characterized population-based primary and secondary health-care-related administrative data, including hospital, physician, and ED visit-related diagnoses up to 29 years before MS onset (the first demyelinating event) compared to a matched population without MS.”
The matched retrospective cohort study used data from 1991 to 2020 from patients in Ontario, Canada.
Image: Pixabay/Thirdman
