Socioeconomic disadvantage may be a potential risk factor for poor clinical outcomes in patients with multiple sclerosis (MS). A retrospective analysis was conducted to assess this association and open the discussion for possible solutions.
Patients with multiple sclerosis (MS) who are at a socioeconomic disadvantage may bear a high burden of disease and worse outcomes. Socioeconomic disadvantage encompasses socioeconomic status and accounts for neighborhood and interpersonal influences. Some studies have found that socioeconomic disadvantage is linked to poor treatment access and disease severity in patients with myocardial infarction and chronic kidney disease. However, limited studies have assessed the impact of socioeconomic disadvantage on the development of disability with MS.
A longitudinal, retrospective analysis was conducted at the Cleveland Clinic Mellen Center using data gathered from routine care visits between June 2015 and September 2020. Researchers utilized a composite measure of neighborhood socioeconomic disadvantage called the Area Deprivation Index (ADI) to analyze the link between MS outcomes and Quality of Life in Neurological Disorders (Neuro-QoL) measures. Clinical data was obtained through a MS Performance Test (MSPT), Quality of Life in Neurological Disorders, and Patient Determined Disease Steps (PDDS) assessment with a mobile tablet.
Around 66% of patients in the study were living with relapse-remitting MS (RRMS), 18% were living with secondary progressive MS (SPMS), and 16% were living with primary progressive MS (PPMS). Results showed that approximately 64% of patients with RRMS and 43% of patients with progressive MS had private health insurance. In addition, higher ADI scores were associated with Medicaid coverage. In areas with the highest neighborhood-level disadvantage, patients experienced more disability, as measured by MSPT.
Healthcare professionals are encouraged to consider socioeconomic disadvantage as a potential predictive risk factor for poor outcomes with MS. Formulating personalized treatment regimens and educating patients with MS on community resources are valuable ways to address socioeconomically disadvantaged patients.
Source:
Abbatemarco, J. R., Carlson, A., Ontaneda, D., McGinley, M., Bermel, R. A., Husak, S., Bruckman, D., Schold, J. D., & Miller, D. M. (2022). Association of socioeconomic disadvantage and neighborhood disparities with clinical outcomes in multiple sclerosis patients. Mult Scler Relat Disord, 61, 103734. https://doi.org/10.1016/j.msard.2022.103734
