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. 2019 Aug:33:88-93.
doi: 10.1016/j.msard.2019.05.024. Epub 2019 May 30.

Access and unmet needs to multiple sclerosis care in a cohort of Argentinean patients

Edgar Carnero Contentti  1 , Juan Pablo Pettinicchi  2 , Pablo A López  2 , Ricardo Alonso  3 , Orlando Garcea  3 , María Eugenia Balbuena  4 , Christian Bortoluzzi  5 , Emanuel Silva  5 , Mariela Cabrera  6 , María Celeste Curbelo  7 , Javier Pablo Hryb  8 , José Luis Di Pace  8 , Mónica Perassolo  8 , Sebastián Ianardi  9 , Carolina Mainella  10 , Surai Mellinger  11 , Leonel Migliacci  12 , Fátima Pagani Cassara  13 , Vladimiro Sinay  13 , Adriana Carra  13 , Mathias Qüesta Laudani  14 , Emiliano Ruiz Romagnoli  15 , Susana Liwacki  15 , Raúl Piedrabuena  15 , Santiago Tizio  16 , Verónica Tkachuk  4
Affiliations

Access and unmet needs to multiple sclerosis care in a cohort of Argentinean patients

Edgar Carnero Contentti et al. Mult Scler Relat Disord. 2019 Aug.

Abstract

Background: Multiple sclerosis (MS) has a low prevalence in Argentina. However, MS has a high burden of disease, which implies frequent neurological visits, magnetic resonance images (MRI) use and chronic MS medication during follow-up, with a high impact on the healthcare system. Therefore, MS care is essential to optimize disease management and improve patients' outcome. We aimed to evaluate the access and barriers to MS care and identified differences in treatment and management of MS patients over a period of 12 months in an Argentinean cohort.

Methods: A cross-sectional study based on a self-administered survey was carried out from August to December 2017 in 13 provinces from Argentina. MS patients (n = 219) were divided into three groups as follows: prepaid health insurance (PHI), social health insurance (SHI) and state-run health insurance (SRHI, Public Health Ministry) and they were assessed in order to detect differences in employment, access and barriers to MS care (neurological visit, MRI use and MS medication).

Results: A total of 185 (84.5%) MS patients were employed (full-time: 59%), 34 (15.5%) were currently unemployed and 15 (6.8%) retired by MS. In addition, 132 had SHI, 45 PHI and 40 SRHI. No statistical differences were found in disease severity, frequency of neurological visit, waiting time for neurological visit as well as frequency and waiting time for MRI use. MS patients with SRHI experienced a longer waiting time (first prescription and during follow-up) and inappropriate delivery of MS medication during follow-up compared to MS patients with PHI and SHI. A total of 8/45 (17.7%) in PHI, 17/40 (42.5%) in SRHI and 25/132 (18.9%) in SHI did not receive the MS medication as properly as prescribed for their neurologists. PHI was independently associated with appropriate delivery of MS medication (OR = 0.81, p = 0.01).

Conclusion: This study showed that MS patients had access barriers to receive MS medication properly, especially those with SRHI (public sector).

Keywords: Access to MS care; Burden of MS; Healthcare; Latin America; Multiple sclerosis.

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