Defining the prodromal phase of multiple sclerosis based on healthcare access in a Portuguese population - ProdMS study

• Published in: Multiple sclerosis and related disorders 2021-10, Vol.55, p.103154-103154, Article 103154
• Main Authors: Jorge, André, André, Ana, Rocha, Ana Luísa, Figueiredo, Carlos, Santos, Mónica, Freitas, Eduardo, Sousa, Lívia, Shamasna, Motasem, Salgado, Vasco, de Sá, João, Cerqueira, João, Vale, José, Sá, Maria José, Correia, Inês
• Format: Article
• Language: English
• Subjects: Healthcare use; Multiple sclerosis; Portuguese multicentric study; Prodromal phase; Prodromal symptoms
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2021.103154

•A prodromal phase in Multiple Sclerosis is being consistently recognised.•This phase usually precedes diagnosis by 5-10 years.•Prodromal phase is associated with a high frequency of healthcare use.•Prodromal symptoms are nonspecific, including musculoskeletal and gastrointestinal.•This phase has a high request rate of complementary exams requests. Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system. Prodromal symptoms and higher healthcare use have been suggested in patients who later develop MS. Assess the healthcare utilization pattern of relapsing-remitting MS (RRMS) patients in the five years prior to MS diagnosis. Retrospective, multicentric study. Demographic and clinical data, drug prescriptions and diagnostic tests were collected from electronic health records five-years previous to MS diagnosis and compared with national data. Included 168 patients, 112 (66.7%) female, median age 34±11 years. The mean number of healthcare use per patient per year was 3.14±2,69, most of them in primary healthcare (47%). Most frequent symptoms were musculoskeletal (22%), gastrointestinal (17%), sensitive (14%) and sensory organs (14%). Median number of diagnostic tests per patient was 6 (IQR 7), and drug prescriptions per patient was 6 (IQR 9). Most frequently prescribed drugs were analgesic/anti-inflammatories, antibiotics and anxiolytics and there was a high request rate of MRIs. RRMS patients had a high frequency of healthcare utilization when compared to national data. This supports the current evidence showing a prodromal phase in MS.