Transition to secondary progressive multiple sclerosis: The consequences for patients and healthcare systems, a healthcare professional survey

Health Science Reports

卷:5

Martin Edward Duddy¹  Stephen Maxwell Montgomery²  Fern Amy Woodhouse²  Michel Anton Kroes³  Sophie Clare Laura Caseby⁴ 

[1] Department of Neurology Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK;

[2] HTA Division Costello Medical Cambridge UK;

[3] Health Economics and Outcomes Research Novartis Pharmaceuticals UK Limited London UK;

[4] Market Access Division Costello Medical London UK;

关键词: disease‐modifying therapies;    multiple sclerosis;    progressive;    quality of life;    symptomatic treatment;   

DOI  :  10.1002/hsr2.474

来源: DOAJ

【 摘 要 】

Abstract Background and Aims Transition to secondary progressive multiple sclerosis (SPMS) from relapsing‐remitting MS (RRMS) is an expected part of the disease trajectory for most patients. However, the transition is challenging to identify due to the gradual nature of progression, and the complications of superimposed relapses, comorbidities, and natural variability in symptoms. This healthcare professional (HCP) survey sought to characterize the transition to and management of SPMS in UK clinical practice. Methods Telephone interviews with 20 neurologists and MS specialist nurses from England and Scotland gathered quantitative and qualitative responses. Numerical analyses and theoretical thematic methods were used to identify key emerging themes. Results The burden SPMS imposes on patients and caregivers was a major theme; discharge from specialist services is common, leading to a sense of abandonment. Respondents acknowledged substantial hesitancy toward identifying SPMS, predominantly due to restricted options of licensed and reimbursed disease‐modifying therapies (DMTs) for SPMS compared with RRMS. Currently, HCPs continue DMTs under a label of RRMS, even after recognition of progression. This survey identified MS to be unusual in comparison with other disease areas in that reimbursement guidelines have a direct impact on clinicians' decisions around disease staging. Respondents suggested reimbursed DMTs proven to slow disability progression in SPMS will create a step‐change in identifying SPMS, providing rationale to acknowledge progression earlier while removing key obstacles to identification. To aid this change, respondents identified a need for SPMS‐specific diagnostic guidance, despite substantial divergence in implementation of current guidance. Conclusions In contrast to the current heterogeneity, a more structured and standardized approach to the identification of SPMS, along with guidelines on treatment, will ensure patients can maximally benefit as treatment options for SPMS evolve.

【 授权许可】

Unknown