Observational study assessing demographic, economic and clinical factors associated with access and utilization of health care services of patients with multiple sclerosis under treatment with interferon beta-1b (EXTAVIA)

PLoS One. 2014 Nov 24;9(11):e113933. doi: 10.1371/journal.pone.0113933. eCollection 2014.

Abstract

Multiple sclerosis (MS) results in an extensive use of the health care system, even within the first years of diagnosis. The effectiveness and accessibility of the health care system may affect patients' quality of life. The aim of the present study was to evaluate the health care resource use of MS patients under interferon beta-1b (EXTAVIA) treatment in Greece, the demographic or clinical factors that may affect this use and also patient satisfaction with the health care system. Structured interviews were conducted for data collection. In total, 204 patients (74.02% females, mean age (SD) 43.58 (11.42) years) were enrolled in the study. Analysis of the reported data revealed that during the previous year patients made extensive use of health services in particular neurologists (71.08% visited neurologists in public hospitals, 66.67% in private offices and 48.53% in insurance institutes) and physiotherapists. However, the majority of the patients (52.45%) chose as their treating doctor private practice neurologists, which may reflect accessibility barriers or low quality health services in the public health system. Patients seemed to be generally satisfied with the received health care, support and information on MS (84.81% were satisfied from the information provided to them). Patients' health status (as denoted by disease duration, disability status and hospitalization needs) and insurance institute were found to influence their visits to neurologists. Good adherence (up to 70.1%) to the study medication was reported. Patients' feedback on currently provided health services could direct these services towards the patients' expectations.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Chi-Square Distribution
  • Female
  • Health Services / economics
  • Health Services / statistics & numerical data*
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Interferon beta-1b / therapeutic use*
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Retrospective Studies
  • Socioeconomic Factors
  • Young Adult

Substances

  • Interferon beta-1b

Grants and funding

The study was sponsored by Novartis Hellas S.A. (Greece). The funder Novartis Hellas S.A. provided support in the form of salaries for authors MV, GV and DG, and was responsible for protocol development, study coordination and site monitoring. The specific roles of these authors are articulated in the ‘author contributions’ section. Novartis also provided a standard pre-defined fee to investigators' research sites for each patient visit, according to GCP guidelines and internal Novartis processes. Novartis Hellas S.A. also funded BECRO, Pharmaceutical Services to perform statistical analysis of the data. Co-authors DM and EZ are employed by BECRO, Pharmaceutical Services. BECRO, Pharmaceutical Services provided support in the form of salaries for authors DM and EZ, but did not have any additional role in the study design, data collection and interpretation, decision to publish, or preparation of the manuscript.