| Abstrakt: |
BACKGROUND: Pediatric multiple sclerosis (MS) accounts for 3.5% to 5% of all patients with MS. At present there is insufficient knowledge of health care utilization trends and potential barriers that adolescent MS patients experience especially when transitioning to adult MS clinics. Social determinants of health may contribute to health care utilization inequity in this population. OBJECTIVES: Describe population health care utilization trends and identify unique potential barriers faced by young adults with MS in a national cohort. METHODS: Preliminary deidentified data was obtained by TriNetX, a health research network providing access to electronic medical records that includes 61 health care organizations (HCOs) in the US. Patients with at least 3 visits using International Classification of Diseases, Tenth Revision code of MS (ie, G35.0) were queried from the database between 2008 and 2023. RESULTS: Of the 267,457 unique patients identified with MS in the TriNetX database, 1422 were stratified in the 11 to 17 age group, 6608 in the 18 to 25 age group, and 8774 in the 26 to 31 age group. Of those within the 18 to 25 age group, 67.0% (n = 4599) were women, 63.0% (n = 4163) identified as White, and 12.5% (n = 823) identified as Black. Within the 3 age groups, 52.9% of patients reported having been prescribed 1 or more MS disease-modifying therapies (DMTs): 20.2% (n = 1794) received glatiramer acetate, 17.1% (n = 1521) interferons, 16.8% (n = 1491) B-cell depleting treatments, 14.9% (n = 1295) fumarates, 7.5% (n = 673) S1P receptors, and 23.7% (n = 2108) other DMTs. Sensitivity analysis, including the prevalence of DMTs groups among age groups, sex, and race, will be conducted. Univariate and multivariate models will be applied to determine if social barriers are associated with the use of DMTs for drug adherence rate and frequency of MS-related procedures/cares. CONCLUSIONS: TriNetX, provides a multiethnic, real-world national cohort for investigating health care utilization by adolescents with MS transitioning to young adulthood care. Determining the critical barriers and social factors interfering with continuity of care will provide insights to optimize the clinical management of these vulnerable patients. [ABSTRACT FROM AUTHOR] |
