How do patients enter the healthcare system after the first onset of multiple sclerosis symptoms? The influence of setting and physician specialty on speed of diagnosis.

Details

Serval ID
serval:BIB_12D62389F084
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
How do patients enter the healthcare system after the first onset of multiple sclerosis symptoms? The influence of setting and physician specialty on speed of diagnosis.
Journal
Multiple sclerosis
Author(s)
Barin L., Kamm C.P., Salmen A., Dressel H., Calabrese P., Pot C., Schippling S., Gobbi C., Müller S., Chan A., Rodgers S., Kaufmann M., Ajdacic-Gross V., Steinemann N., Kesselring J., Puhan M.A., von Wyl V.
Working group(s)
Swiss Multiple Sclerosis Registry
ISSN
1477-0970 (Electronic)
ISSN-L
1352-4585
Publication state
Published
Issued date
04/2020
Peer-reviewed
Oui
Volume
26
Number
4
Pages
489-500
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Diagnosing multiple sclerosis (MS) early is crucial to avoid future disability. However, potentially preventable delays in the diagnostic cascade from contact with a physician to definite diagnosis still occur and their causes are still unclear.
To identify the possible causes of delays in the diagnostic process.
We analyzed the data of the Swiss MS Registry. With logistic regression, we modeled the time from the first contact to the first consultation (contact-to-evaluation time, ⩽1 month/>1 month) and the evaluation-to-diagnosis time (⩽6 months/>6 months). Potential factors were health system characteristics, sociodemographic variables, first symptoms, and MS type.
We included 522 participants. Mostly, general practitioners (67%) were contacted first, without delaying the diagnosis. In contrast, first symptoms and MS type were the major contributors to delays: gait problems were associated with longer contact-to-evaluation times, depression as a concomitant symptom with longer evaluation-to-diagnosis times, and having primary progressive MS prolonged both phases. In addition, living in mountainous areas was associated with longer contact-to-evaluation times, whereas diagnosis after 2000 was associated with faster diagnoses.
For a quicker diagnosis, awareness of MS as a differential diagnosis of gait disorders and the co-occurrence of depression at onset should be raised, and these symptoms should be attentively followed.
Keywords
Registries, delayed diagnosis, epidemiology, patient-reported outcomes, regression analysis, time to diagnosis
Pubmed
Web of science
Open Access
Yes
Create date
17/09/2019 14:32
Last modification date
02/09/2020 6:22
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