Importance of Bodily Functions in Neuromyelitis Optica Spectrum Disorder from Neurologists’ Perspective
Nieves Téllez Lara1, Rocío Gómez2, Marta Aguado-Valcarcel3, María Sepúlveda4, Álvaro Cobo-Calvo5, Aida Orviz-García6, María Díaz Sánchez7, Sabas Boyero8, Pablo Rebollo9, Jorge Maurino2
1Hospital Clínico Universitario de Valladolid, 2Medical Department, Roche Farma, 3Hospital Universitario Álvaro Cunqueiro, 4Hospital Clínic de Barcelona, 5Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, 6Fundacion Jimenez Diaz, 7Hospital Universitario Virgen del Rocío, 8Hospital Universitario Cruces, 9IQVIA
Objective:

The study’s aim was to assess the importance given by neurologists to the bodily functions of patients with neuromyelitis optica spectrum disorder (NMOSD).

Background:

NMOSD can lead to multiple impairments in several functional systems, causing heterogeneous symptoms. Some might be under-recognized by physicians and of high value for patients.

Design/Methods:

An online, cross-sectional study was conducted in collaboration with the Spanish Society of Neurology. Neurologists assisting NMOSD patients proactively answered a survey composed of demographic characteristics, professional background, and behavioral traits. Importance of patients’ bodily functions was assessed through the Values of Bodily Functions Questionnaire (VABOF), which covers 13 functions. A stepwise multivariate linear regression analysis was used to determine the association between neurologists’ characteristics and functions’ importance.

Results:

A total of 104 neurologists were included [median interquartile range (IQR) age: 34.5 (29.0-44.0) years, 52.9% male, median (IQR) experience managing NMOSD patients: 5.0 (2.9-10.8) years].

Neurologists placed the greatest importance on Speech [mean (SD): 4.3 (2.9)], followed by Thinking and memory [4.4 (3.2)], and Visual function [4.6 (2.4)]. The least prioritized functions were Wakefulness and alertness [8.9 (3.7)], Sexuality [10.7 (2.5)], and Normal skin sensations [11.1 (2.6)].

Importance of functions varied according to age, sex, experience, NMOSD specialization, number of patients, last congresses attendance, attitude towards innovation, care-related regret, and empathy, although general ranking positions were similar. Fewer years of experience and higher empathy were predictors of placing Speech as a prioritized function (p<0.01), whereas last congresses attendance and lower intensity of care-related regrets were predictors of a lower prioritization of Normal skin sensations (p<0.02).

Conclusions:

These results highlight the importance given by neurologists to speech, cognition, and visual over other functions. Assessing the physicians’ perspective in this regard might be of importance to undercover which functions are prioritized from their view and to reach an agreement with patients towards a patient-centred care.

10.1212/WNL.0000000000205816