MS Patients Who Adhere to Treatment Have Higher Health Costs-And Better Outcomes

CHICAGO, Nov. 27, 2017  -- Researchers examined the insurance claims and medical records of 681 patients with multiple sclerosis (MS) and found those who adhered to medication schedules had significantly better physical outcomes than patients who did not, although the total overall costs for their care were higher.

The findings, published in the December edition of The Journal of the American Osteopathic Association, are considered significant because it is harder to assess treatment results for patients with MS than for those with other chronic illnesses, making it difficult to determine whether the treatment benefits justify their cost.

Researchers noted that the disease has few easily obtainable objective measures, like blood pressure or glucose levels. For patients with MS, disease activity is primarily measured through imaging studies, which can identify new lesions in the event of a relapse. Those studies are expensive and aren't routinely performed or captured in a quantitative fashion.

"Payers often look at near-term improvement to determine whether a treatment is effective and worth the cost," says Carl Hoegerl, DO, a neurologist at the Liberty University College of Osteopathic Medicine and a co-researcher on this study. "But the case for MS treatment becomes evident when you see that the rate of decline becomes much slower and less severe."

Comparing the experiences of MS patients with high adherence to treatments to those with low adherence, the study found patients with highest adherence reported the disease's physical impact as 14 percent less severe and the psychological impact 17 percent less severe. Patients with high adherence also rated their level of disability 12 percent lower and believed their treatments to be 7 percent more effective.

Dr. Hoegerl said that patients with untreated MS face a sharper decline in their ability to walk and move. They can also experience pain, numbness and tingling in their extremities.

MS is the most common cause of neurologic disability in adults, with about 135 cases per 100,000 Americans. About 12,000 new cases of MS are reported annually. While there is no cure, 12 FDA-approved treatments are currently available for patients with the disease.

"As an osteopathic physician, I'm focused on partnering with patients to achieve their health goals, which for most MS patients involves maintaining their physical functions for as long as possible," said Dr. Hoegerl. "We know that proper treatment of MS improves the quality of patients' lives and extends them to almost the length of the average person."

The study was conducted at Geisinger Health System, an integrated delivery system in central and northeastern Pennsylvania that includes an insurance provider, Geisinger Health Plan. The study included adults whose records included MS diagnostic codes and medication orders for MS therapies.

The two phase study of patients from January 1, 2004 to December 31, 2013 included a retrospective analysis of electronic health records and insurance claims plus a prospective analysis of self-reported medication adherence. The health outcomes considered included inpatients admission, emergency room visits, outpatient appointments and health care costs. All-cause versus MS-related costs were calculated separately, with all costs adjusted for inflation to 2013 dollars.

Editor's Note: The authors reported no financial disclosures. This study was supported by an institutional research grant from Biogen.

About The Journal of the American Osteopathic AssociationThe Journal of the American Osteopathic Association (JAOA) is the official scientific publication of the American Osteopathic Association. Edited by Robert Orenstein, DO, it is the premier scholarly peer-reviewed publication of the osteopathic medical profession. The JAOA's mission is to advance medicine through the publication of peer-reviewed osteopathic research.

SOURCE American Osteopathic Association press release 

A Mom With MS Finds Nasty Note After Parking In Handicapped Spot

"You need to think twice before judging someone," the Plainfield mom said. " You have no idea what they've been through."

article by Shannon Antinori,  for Patch Media | Nov 15, 2017                                                     

PLAINFIELD, IL — From all outward appearances, Michele Clarke, 39, looks young and healthy. But 16 years ago, the Plainfield mom was diagnosed with multiple sclerosis. Since then she has had to battle back from flare-ups that have at times left her using a cane or a wheelchair, and even hospitalized for weeks at a time.

"Then there's times when I'm able to go to the gym and build up my strength," she told Patch.

Like many who suffer from "invisible diseases," Clarke said that for many years she was hesitant about using the handicapped placard for fear of being judged.

"It almost gets to the point where I'm afraid to use it," she said, "just because I'm not in a walker or I'm not using a cane ... I may look good on the outside, but on the inside I'm struggling."

Her fears came true on Monday, Clarke said, when she took her 12-year-old daughter to a doctor's office on 127th Street in Plainfield. As she was getting into the car, her daughter handed her a note that had been left on the passenger side windshield.

Clarke said she initially thought she might have been ticketed for forgetting to put her placard in the window, and checked to make sure the placard was there. When she unfolded the piece of paper and began to read, Clarke burst into tears.

"You inconsiderate bitch," a stranger had written. "Parking in a handicap spot when you and your little daughter aren't handicapped. Is the placard for someone else in your family? It certainly isn't for either of the two of you. People who are are truly handicapped need these spots — not you. You are setting a very poor example for your daughter!"

Clarke said her daughter consoled her, telling her it was OK.

"I opened (the note) up and I just had tears rolling down my face after the first nasty words," Clarke said. "I could tell she was hurt for me."

Clarke said she debated about sharing the note on social media, but decided to speak out.

"People do have these invisible diseases, and you get this judgement because you're not using a walker or in a wheelchair," she said. "How do you educate people out there about not judging?"


She said her post was shared on the Facebook pages of two local moms groups, which generated hundreds of comments from others who have experienced similar judgment. Clarke said reading those stories made her feel less alone.

"That was good for me to hear," she said.

Clarke said she wishes the person who left the note would have taken the time to talk to her instead of waiting for her to go inside and leaving an angry message.

"Don't leave a nasty note," she said. "Shame on you for leaving something like that knowing I was with my daughter, who had to see me cry."

Judgement against those with chronic disease — especially for young people who are ill — is so prevalent that the Invisible Disabilities Association is dedicated to combating it. The association defines an invisible disability as "a physical, mental or neurological condition that limits a person's movements, senses, or activities that is invisible to the onlooker."

"Unfortunately," a statement from the association explains, "the very fact that these symptoms are invisible can lead to misunderstandings, false perceptions and judgments."

Last week in Kentucky, a college student undergoing radiation for a brain tumor told CBS News she came out of school to find her car vandalized. An unkind note similar to the one Clarke got was left on it. The note bore a logo that read, "Not really (handicapped parking symbol) just lazy."

Clarke said she said she hopes the person who left the note sees her story.

"I'm not looking for an apology," she said. "But you need to think twice before judging someone ... You don't know what they have. You have no idea what they've been through — who are we to say, 'They look fine, they shouldn't be parking in a handicapped spot?'"

Image courtesy of Michele Clarke

https://patch.com/illinois/plainfield/mom-ms-finds-nasty-note-after-parking-handicapped-spot