Defining the prodromal phase of multiple sclerosis based on healthcare access in a Portuguese population - ProdMS study

• DOI: 10.1016/j.msard.2021.103154
• Publication Date: 2021-07-19T22:23:34Z
• Authors: André Jorge; Ana André; Ana Luísa Rocha; Carlos Figueiredo; Mónica Santos; Eduardo Freitas; Lívia Sousa; Motasem Shamasna; Vasco Salgado; João de Sá; João Cerqueira; José Vale; Maria José Sá; Inês Correia
• Keywords: Adult; Young Adult; 03 medical and health sciences; Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; 0302 clinical medicine; Portugal; Humans; Female; Middle Aged; Health Services Accessibility; Retrospective Studies; 3. Good health

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system. Prodromal symptoms and higher healthcare use have been suggested in patients who later develop MS.Assess the healthcare utilization pattern of relapsing-remitting MS (RRMS) patients in the five years prior to MS diagnosis.Retrospective, multicentric study. Demographic and clinical data, drug prescriptions and diagnostic tests were collected from electronic health records five-years previous to MS diagnosis and compared with national data.Included 168 patients, 112 (66.7%) female, median age 34±11 years. The mean number of healthcare use per patient per year was 3.14±2,69, most of them in primary healthcare (47%). Most frequent symptoms were musculoskeletal (22%), gastrointestinal (17%), sensitive (14%) and sensory organs (14%). Median number of diagnostic tests per patient was 6 (IQR 7), and drug prescriptions per patient was 6 (IQR 9). Most frequently prescribed drugs were analgesic/anti-inflammatories, antibiotics and anxiolytics and there was a high request rate of MRIs.RRMS patients had a high frequency of healthcare utilization when compared to national data. This supports the current evidence showing a prodromal phase in MS.