An Overview of Multiple Sclerosis Care in Rural and Urban Newfoundland and Labrador

Area of Science:

• Neurology
• Public Health

Background:

• Limited access to multiple sclerosis (MS)-focused care in rural areas negatively impacts quality of life, physical, and mental health.
• Geographic disparities in healthcare access pose challenges for individuals with MS.

Purpose of the Study:

• To compare demographic and clinical outcomes of MS patients in urban, semi-urban, and rural settings in Newfoundland and Labrador.
• To assess the impact of residence location on disability, fatigue, pain, anxiety, depression, and disease activity.

Main Methods:

• Prospective study involving MS patients assessed by a neurologist.
• Data collection included clinical history, diagnosis, disease-modifying therapy (DMT) use, and validated measures of disability, fatigue, pain, heat sensitivity, depression, and anxiety.

Main Results:

• No demographic differences were found between rural and urban MS patients.
• Physical disability and disease activity indicators were similar across all residential settings.
• Semi-urban residents received more high-efficacy DMTs, while urban and rural residents received more moderate-efficacy DMTs. Anxiety was more prevalent than depression across all settings, with rural residents reporting higher depression levels.

Conclusions:

• Despite higher depression rates in rural areas, MS patients in rural and urban Newfoundland and Labrador receive comparable levels of care and continuity.
• Geographic location did not significantly impact physical disability or disease activity in MS patients.