Abstract Details

Title Risk Disease Disparity Among Ethnic Groups in Multiple Sclerosis (MS)—A Retrospective Cohort Study

Topic Multiple Sclerosis

Presentation(s) S7 - Multiple Sclerosis: Special Populations and Non-MS CNS Neuroinflammatory Disease (4:42 PM-4:54 PM)

Poster/Presentation
Number 007

Background

MS is a common, chronic disease with a recognized race disparity. There is increased urgency to document, assess barriers, and reduce racial and economic disparities in care.

Objective To describe race differences in a cohort of people with MS.

Design/Methods We performed a retrospective cohort analysis of patients seen at 18 outpatient neurology clinics within an academic health system between June 2018, and August 2023. Patient-Reported Outcomes Measurement Information System (PROMIS) were collected. We assessed associations between demographic variables and healthcare rate utilization (HRU) data at specific time points between HRU events and index neurology clinic visits using a logit model. Demographic data was combined with Health Plan claims HRU data in 2 domains (Hospitalization and Emergency Department (ED) treat and release all causes) at 7, 30 and 90-days from an index neurology clinic visit.

Results

MS patient cohort included 1929 unique patients (5199 encounters; 75.8% females, 5.9% black, median age 53.2 years). The MS patient cohort showed significantly lower hospitalizations and ED visits, at 30- and 90-day time-points, compared to the general neurology cohort (N=64808, 62.6% females) (p<0.05). Black MS patients (106 patients, 238 encounters) correlated with increased ED visits at 30 and 90-day time-points compared to the general neurology cohort (p<0.05). Within the MS patient cohort: Black race also correlated with increased 90-day hospitalizations (p<0.05). Medicaid was the insurance in 30.7% of the black MS population and in 13.3% for white MS patient population. Higher pathologic scores in PROMIS measures (Anxiety>62, Depression>60) were present in the black MS population (29.4%, 31.9%) compared to white MS population (17.8%, 23.3%). In contrast, antidepressants were used in 42% of black MS patients and 55.9% of white MS patients.

Conclusions

Black MS patients have associated higher unplanned HRU and pathologic PROMIS scores. The observed differences should guide development of targeted tools for timely care interventions.

Authors/Disclosures
Ingrid P. Loma-Miller, MD (University of Pittsburgh Medical Center) PRESENTER	Dr. Loma-Miller has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Loma-Miller has received research support from Novartis.
Rock A. Heyman, MD (UPMC)	Dr. Heyman has nothing to disclose.
Parthasarathy Thirumala, MD, FAAN (University of Pittsburgh Medical Center)	The institution of Dr. Thirumala has received research support from University of Pittsburgh.
Alexandra Urban, MD, FAAN (University of Pittsburgh School of Medicine)	Dr. Urban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuropace. Dr. Urban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SK Life Science, Inc.