Healthcare Utilization Barriers in Multiple Sclerosis Patients Transitioning from Adolescent to Adult Care: A Multi-institutional Database Analysis in the United States
Trieste Francis1, Ka-Ho Wong1, Heewon Hwang1, Melissa Wright1, John Rose1
1Neurology, University of Utah
Objective:

Describe population healthcare utilization trends and identify unique potential barriers faced by young adults with MS in a national cohort. 

Background:

Pediatric multiple sclerosis (diagnosis in patients < 18 years old) accounts for 3.5%−5% of all patients with multiple sclerosis. There is a dearth of literature on healthcare utilization trends and potential barriers that adolescent MS patients experience when transitioning to adult MS clinics. Social determinants of health may contribute to healthcare utilization inequity in this population.

Design/Methods:

Preliminary de-identified data was obtained by TriNetX, a health research network providing access to electronic medical records that includes sixty-one healthcare organizations (HCOs) in the US. Patients with the ICD-10 code of MS (G35.0) were queried from the database between 2008-2023. Patients with less than three visits coded with ICD-10 codes of G35.0 will be excluded from the final analysis. Data on DMT use, frequency of clinical visits, and demographic information related to social determinants of health were extracted.

Results:

Of the 267,457 unique patients identified with MS in the TriNetX database, 1,422 were stratified in the 11-17 age group, 6,608 in the 18-25 age group, and 8,774 in the 26-31 age group. Of those within the 18-25 age group, 67.0% (n=4,599) are female, 63.0% (n=4,163) identified as white, and 12.5% (n=823) identified as black. Only 38% of MS patients within the three age groups in this data set are reported to be prescribed MS disease-modifying therapies; further sensitivity analysis will be performed within each age group on DMTs and frequency of clinical visits and related procedures. 

Conclusions:

TriNetX provides a multiethnic, real-world national cohort for investigating healthcare utilization by adolescent MS patients transitioning to young adulthood.  Determining the critical barriers and social factors interfering with continuity of care will provide insights to optimize the clinical management of these vulnerable patients.

10.1212/WNL.0000000000205335