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Published on: December 9, 2015
Evaluation of Documented Infections by Provider Specialty in Patients with Multiple Sclerosis Receiving
Peiqing Qian1, Jenna Brunn2, Wennifer Giglio3
1Swedish Neuroscience Institute, Seattle, WA, USA.
Introduction:
People with multiple sclerosis (pwMS) have an increased risk of infections. There are limited data characterizing who initially diagnoses infections in pwMS and how these are communicated among healthcare providers.
Methods:
Retrospective US claims data from January 1, 2017 to August 31, 2024 were used to identify newly diagnosed pwMS aged 18-64 years who were taking any disease-modifying therapy (DMT) for ≥ 90 days. Index date was the earliest date of the first DMT claim. Infections were based on International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Severe infections included events requiring hospitalization and/or intravenous antibiotics.
Results:
Overall, 69,148 pwMS who were treatment-naïve met eligibility criteria. Mean age was 44.1 years; 72% were female; and 81% were < 1 year from initial MS diagnosis to DMT initiation. A total of 316,497 infection events were reported over the study period, with 98% first reported by non-neurology providers. There were 21,416 severe infection events reported, of which > 98% were first reported by non-neurologists. In pwMS with infection events first reported by non-neurologists, 6% had a neurology visit ≤ 7 days after initial infection; of those, 8% had any infection ICD-10-CM code recorded at that visit (increased to 19% for serious infections). In the 16% of pwMS with a neurology visit ≤ 30 days post initial infection reported by a non-neurologist, 6% had any infection ICD-10-CM code recorded at that neurology visit (increased to 14% for severe infections).
Conclusion:
Most infections in pwMS are first reported by non-neurology providers, as most pwMS did not interact with their MS clinician in the first few months after infection, even if that infection was severe. These data highlight the importance of communication between different providers and patients to accurately assess patient status and DMT safety, leading to improved patient outcomes.
Insights
Most infections in people with multiple sclerosis (pwMS) are initially diagnosed by non-neurology providers. This highlights a critical gap in communication and timely care for pwMS, impacting patient outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Healthcare Management
Background:
- People with multiple sclerosis (pwMS) face a higher risk of infections.
- Limited data exist on who diagnoses these infections and how care is coordinated among providers.
Purpose of the Study:
- To characterize the initial diagnosis of infections in pwMS.
- To examine the communication and follow-up patterns between healthcare providers for infections in pwMS on disease-modifying therapy (DMT).
Main Methods:
- Retrospective analysis of US claims data (2017-2024) for pwMS (aged 18-64) on DMT.
- Infections identified using ICD-10-CM codes; severe infections defined by hospitalization and/or IV antibiotics.
Main Results:
- Nearly all (98%) infection events in pwMS were first reported by non-neurology providers.
- Over 98% of severe infections were also initially diagnosed by non-neurologists.
- Few pwMS had a neurology visit within 7-30 days of infection diagnosis, with low rates of infection coding during these visits.
Conclusions:
- Non-neurologists frequently diagnose infections in pwMS, including severe cases.
- Lack of timely neurology follow-up post-infection suggests potential gaps in comprehensive care and DMT safety assessment.
- Improved inter-provider communication and patient engagement are crucial for better outcomes in pwMS.
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