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. 2021 Oct;28(10):3403-3410.
doi: 10.1111/ene.14879. Epub 2021 May 14.

Impact of the COVID-19 pandemic on access to healthcare services amongst patients with multiple sclerosis in the Lazio region, Italy

Paola Colais  1 , Silvia Cascini  1 , Maria Balducci  1 , Nera Agabiti  1 , Marina Davoli  1 , Danilo Fusco  2 , Enrico Calandrini  1 , Anna Maria Bargagli  1
Affiliations

Impact of the COVID-19 pandemic on access to healthcare services amongst patients with multiple sclerosis in the Lazio region, Italy

Paola Colais et al. Eur J Neurol. 2021 Oct.

Abstract

Background and purpose: Multiple sclerosis (MS) is a complex chronic, autoimmune inflammatory disease involving multidisciplinary assessments and interventions. Access to outpatient specialist and home healthcare services was explored during the pandemic outbreak and the lockdown amongst MS patients in the Lazio region. Adherence to disease-modifying therapies (DMTs) is also described.

Methods: A population-based study was conducted using regional healthcare administrative databases. A validated algorithm was used to identify MS cases over the period 2011-2018. The numbers of specialist and home-based services were compared between 2019 and 2020. The medication possession ratio was used to measure adherence to DMTs.

Results: A total of 9380 MS patients were identified (68% women). A decline in the number of outpatient care services between March and June 2020 compared to the previous year was observed, in particular for rehabilitation (-82%), magnetic resonance imaging (-56%) and neurological specialist services (-91%). Important year-to-year variations were observed in May and June 2020 in home-based nursing and medical care (-91%) and motor re-education services (-74%). Adherence to DMTs was higher in the first 4 months of 2019 compared to the same period of 2020 (67.1% vs. 57.0%).

Conclusions: A notable disruption of rehabilitative therapy and home-based services as well as in DMT adherence was observed. Since the pandemic is still ongoing and interruption of healthcare services could have a major impact on MS patients, it is necessary to monitor access of MS patients to healthcare resources in order to ensure adequate treatments, including rehabilitative therapies.

Keywords: COVID-19; administrative databases; cohort; healthcare; multiple sclerosis.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Outpatient care delivery. Trend January to June and percentage change 2019–2020 [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Trend January to June and percentage change 2019–2020 in physical medicine and rehabilitation (a), magnetic resonance imaging (b) and neurological specialist services (c) [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Home care services delivery. Trend January to September and percentage change 2019–2020 [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 4
FIGURE 4
Trend January to September and percentage change 2019–2020 in home‐based nursing and medical care, and motor re‐education [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

References

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