移民使用多发性硬化症疾病修饰药物:现实世界研究
Jonas Graf1, Huah Shin Ng1,2, Feng Zhu1
1Division of Neurology, Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Scientific reports
|December 1, 2023
概括
患有多发性硬化症 (MS) 的移民如果社会经济地位较低,就不太可能开始服用疾病修饰药物 (DMD). 总的来说,移民身份与在诊断后五年内开始第一次DMD的几率有关.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多发性硬化症 (MS) 管理包括疾病修饰药物 (DMD).
- 在普遍医疗保健系统中,在患有MS的移民人口中,人们对DMD启动模式知之甚少.
- 了解治疗机会的差异对于公平的MS护理至关重要.
研究的目的:
- 评估移民身份和DMD发病之间的关联,在MS与MS相关的医疗保健第一次接触后的五年内.
- 调查社会经济地位是否改变了移民和DMD使用之间的关系.
- 确定移民人口及时治疗多发性硬化症的潜在障碍.
主要方法:
- 使用加拿大不列颠哥伦比亚省卫生行政数据 (1996-2012年索引日期) 的回顾性队列研究.
- 确定了8762名MS患者 (522名移民) 符合纳入标准 (≥18岁,居住要求).
- 后勤回归分析评估了在指数后五年内填写任何DMD处方的几率,并对共变量进行调整.
主要成果:
- 总的来说,移民身份与在MS相关遭遇的五年内启动第一个DMD的几率有关.
- 较低社会经济地位 (SES) 的移民显示,填写任何DMD处方的几率降低.
- 在更高的SES五分位数中,在移民和长期居民之间没有观察到DMD使用的显著差异.
结论:
- 移民状况是与多发性硬化症疾病修饰药物启动相关的因素.
- 较低的社会经济地位可能会加剧患有多发性硬化症的移民在DMD获得的差异.
- 需要进一步的研究,以解决移民多发性硬化症患者治疗开始的不平等问题.
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