Abstract
Background
In Denmark, specialized multiple sclerosis (MS) clinics offer free-of-charge treatment to people with MS. However, not all people with MS attend regular clinical follow-up.
Objective
To identify people with MS who do not attend Danish MS clinics and identify barriers to treatment.
Methods
The Danish Multiple Sclerosis Registry was linked to other national Danish registries with follow-up from 2000–2020. We used a time-dependent Cox regression to rank factors associated with low attendance to clinical follow-up visits based on the magnitude of hazard ratios (HRs).
Results
We included 10,175 adults with MS, of which 3862 (38%) had less than one visit annually. The five top-ranked factors that reduced the risk of visits occurring included never having received diseases modifying treatment (HR: 0.48; 95%CI: 0.46–0.49), been diagnosed with MS before 2009 (0.79; 0.78–0.81), association with MS center in an outer region of Denmark (0.82; 0.80–0.84), having progressive MS type (0.88; 0.86–0.91) and not having received symptomatic treatment at diagnosis (0.91; 0.89–0.93).
Conclusion
Our results highlight disease-specific and geographic inequalities in the management of people with MS in Denmark. Strategies to prevent this inequality, especially for people with progressive phenotypes and those who need supportive and non-medical treatment and care, should be implemented.
In Denmark, specialized multiple sclerosis (MS) clinics offer free-of-charge treatment to people with MS. However, not all people with MS attend regular clinical follow-up.
Objective
To identify people with MS who do not attend Danish MS clinics and identify barriers to treatment.
Methods
The Danish Multiple Sclerosis Registry was linked to other national Danish registries with follow-up from 2000–2020. We used a time-dependent Cox regression to rank factors associated with low attendance to clinical follow-up visits based on the magnitude of hazard ratios (HRs).
Results
We included 10,175 adults with MS, of which 3862 (38%) had less than one visit annually. The five top-ranked factors that reduced the risk of visits occurring included never having received diseases modifying treatment (HR: 0.48; 95%CI: 0.46–0.49), been diagnosed with MS before 2009 (0.79; 0.78–0.81), association with MS center in an outer region of Denmark (0.82; 0.80–0.84), having progressive MS type (0.88; 0.86–0.91) and not having received symptomatic treatment at diagnosis (0.91; 0.89–0.93).
Conclusion
Our results highlight disease-specific and geographic inequalities in the management of people with MS in Denmark. Strategies to prevent this inequality, especially for people with progressive phenotypes and those who need supportive and non-medical treatment and care, should be implemented.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Multiple Sclerosis Journal - Experimental, Translational and Clinical |
| Vol/bind | 10 |
| Udgave nummer | 4 |
| Antal sider | 14 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:The authors thank participants and staff of the Danish Multiple Sclerosis Register for their important contribution. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Danish Ministry of Health.
Publisher Copyright:
© The Author(s), 2024.