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- 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.
- Authors
Barin, Laura; Kamm, Christian P; Salmen, Anke; Dressel, Holger; Calabrese, Pasquale; Pot, Caroline; Schippling, Sven; Gobbi, Claudio; Müller, Stefanie; Chan, Andrew; Rodgers, Stephanie; Kaufmann, Marco; Ajdacic-Gross, Vladeta; Steinemann, Nina; Kesselring, Jürg; Puhan, Milo A; von Wyl, Viktor
- Abstract
Background: 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. Objective: To identify the possible causes of delays in the diagnostic process. Methods: 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. Results: 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. Conclusion: 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.
- Subjects
MULTIPLE sclerosis; PHYSICIANS; GAIT disorders; GENERAL practitioners; LOGISTIC regression analysis
- Publication
Multiple Sclerosis Journal, 2020, Vol 26, Issue 4, p489
- ISSN
1352-4585
- Publication type
Article
- DOI
10.1177/1352458518823955