Greater Age and Comorbidity Burden Are Linked to Increased MS Care Consumption

Female doctor writing notes while talking to male patient in hospital ward
Among patients with multiple sclerosis, those of older age and higher comorbidity burden are associated with the highest care consumption.

Clinicians across multiple specialties who care for persons with multiple sclerosis (PwMS) have a wide range of the number annual consultations with patients, with older age and higher comorbidity burden associated with highest care consumption among patients with multiple sclerosis (MS), according to study results published in the Multiple Sclerosis Journal.

This study included an assessment of linked health administrative and clinical data from British Columbia, Canada. Data consisted of physician visits, hospital admissions, and prescriptions dispensed from outpatient and community pharmacies.

Using these data, study investigators developed 2 cohorts: incident MS cases (n=1048) and prevalent MS cases (n=3180). A multichannel sequence analysis (MCSA) was applied to this analysis to quantify and compare care pathways of PwMS, accounting for all-cause hospitalizations and physician visits. The physician visits were divided into 5 specialties, including neurologists, psychiatrists, general practitioners, internal medicine specialists, and “other” (physical medicine and rehabilitation specialists, ophthalmologists, and urologists).

Study investigators used demographic and clinical features in the MCSA to identify and characterize 12 and 6 distinct care consumption clusters among incident and prevalent MS cases, respectively. The median follow-up periods were 9.6 and 13.0 years, respectively, for incidence and prevalent cases.

Across incident and prevalent MS cases, the median number of annual consultations featured a large range between clusters. The median number of annual consultations for general practitioners was 5.6 to 21.3 compared with 1.2 to 4.6 for neurologists, 0 to 5.3 for psychiatrists, 0 to 0.9 for internal medicine specialists, and 0.3 to 1.8 for other key specialists.

Clusters 3 of the incident cohort and clusters A and E of the prevalent cohort had high numbers of comorbidities. Across cohorts, clusters with higher comorbidity burden and older age at MS symptom onset were associated with higher care consumption across specialties.

This study lacked data on lifestyle and environmental exposures that influence care consumption in PwMS, including obesity, diet, smoking, educational level, or physical activity.

The study investigators concluded that the identified “profiles and methods could help health services planning, and may provide a novel outcome in health research or economic evaluation” in PwMS.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Roux J, Kingwell E, Zhu F, Tremlett H, Leray E; BeAMS Study group. Care consumption of people with multiple sclerosis: A multichannel sequence analysis in a population-based setting in British Columbia, Canada. Published online May 28, 2021. Mult Scler. doi:10.1177/13524585211016726