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Impact of COVID-19 and system recovery in delivering healthcare to people with multiple sclerosis: a population-based Study.

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Title: Impact of COVID-19 and system recovery in delivering healthcare to people with multiple sclerosis: a population-based Study.
Authors: Affinito, Giuseppina (AUTHOR), Trama, Ugo (AUTHOR), Palumbo, Laura (AUTHOR), Fumo, Maria Grazia (AUTHOR), Giordana, Roberta (AUTHOR), Di Gennaro, Massimo (AUTHOR), Triassi, Maria (AUTHOR), Lanzillo, Roberta (AUTHOR), Morra, Vincenzo Brescia (AUTHOR), Palladino, Raffaele (AUTHOR), Moccia, Marcello (AUTHOR)
Source: Neurological Sciences. Nov2023, Vol. 44 Issue 11, p3771-3779. 9p.
Subjects: Multiple sclerosis, COVID-19, Medical care, COVID-19 pandemic, Patient compliance
Geographic Terms: Campania (Italy)
Abstract: Background: COVID-19 pandemic has affected the management of multiple sclerosis (MS). Objective: To explore the impact of COVID-19 on healthcare delivery to people with MS and the subsequent recovery of the system. Methods: In this population-based study in the Campania Region (Italy), we included people with MS across pre-COVID-19, lockdown, pre-vaccination, and vaccination periods. Differences in continuous outcomes between periods were explored using linear mixed models (annualized hospitalization rate (AHR) and adherence measured as medication possession ratio (MPR)). Differences in disease-modifying treatment (DMT) prescription rates (first DMT prescription, any DMT switch, switch from platform to highly effective DMT, and combination of first DMT prescription and any DMT switch) were assessed using an interrupted time series design. Results: Compared with pre-COVID-19, AHR decreased during the lockdown (Coeff = 0.64;95%CI = -0.69, -0.59; p < 0.01), and remained lower during pre-vaccination and vaccination periods. Adherence decreased during pre-vaccination (Coeff = -0.04;95%CI = -0.05, -0.03; p < 0.01) and vaccination periods (Coeff = -0.07;95%CI = -0.08, -0.07; p < 0.01). After the lockdown, there was an increase in any DMT switch (IRR 2.05 95%CI 1.38,3.05; p < 0.01), in switch from platform to highly effective DMTs (IRR 4.45;95%CI 2.48,8.26; p < 0.01) and in first DMT prescriptions (IRR 2.48;95%CI 1.64,3.74; p < 0.01). Conclusions: DMT prescriptions quickly returned to pre-pandemic levels, reflecting good health system recovery. However, adherence has remained lower than the past, as from suboptimal care. Assessing long-term COVID-19 impact on MS healthcare is warranted. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Impact of COVID-19 and system recovery in delivering healthcare to people with multiple sclerosis: a population-based Study.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Affinito%2C+Giuseppina%22&quot;&gt;Affinito, Giuseppina&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Trama%2C+Ugo%22&quot;&gt;Trama, Ugo&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Palumbo%2C+Laura%22&quot;&gt;Palumbo, Laura&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fumo%2C+Maria+Grazia%22&quot;&gt;Fumo, Maria Grazia&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Giordana%2C+Roberta%22&quot;&gt;Giordana, Roberta&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Di+Gennaro%2C+Massimo%22&quot;&gt;Di Gennaro, Massimo&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Triassi%2C+Maria%22&quot;&gt;Triassi, Maria&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lanzillo%2C+Roberta%22&quot;&gt;Lanzillo, Roberta&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Morra%2C+Vincenzo+Brescia%22&quot;&gt;Morra, Vincenzo Brescia&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Palladino%2C+Raffaele%22&quot;&gt;Palladino, Raffaele&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Moccia%2C+Marcello%22&quot;&gt;Moccia, Marcello&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Neurological+Sciences%22&quot;&gt;Neurological Sciences&lt;/searchLink&gt;. Nov2023, Vol. 44 Issue 11, p3771-3779. 9p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Multiple+sclerosis%22&quot;&gt;Multiple sclerosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22COVID-19%22&quot;&gt;COVID-19&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+care%22&quot;&gt;Medical care&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22COVID-19+pandemic%22&quot;&gt;COVID-19 pandemic&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patient+compliance%22&quot;&gt;Patient compliance&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Campania+%28Italy%29%22&quot;&gt;Campania (Italy)&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: COVID-19 pandemic has affected the management of multiple sclerosis (MS). Objective: To explore the impact of COVID-19 on healthcare delivery to people with MS and the subsequent recovery of the system. Methods: In this population-based study in the Campania Region (Italy), we included people with MS across pre-COVID-19, lockdown, pre-vaccination, and vaccination periods. Differences in continuous outcomes between periods were explored using linear mixed models (annualized hospitalization rate (AHR) and adherence measured as medication possession ratio (MPR)). Differences in disease-modifying treatment (DMT) prescription rates (first DMT prescription, any DMT switch, switch from platform to highly effective DMT, and combination of first DMT prescription and any DMT switch) were assessed using an interrupted time series design. Results: Compared with pre-COVID-19, AHR decreased during the lockdown (Coeff = 0.64;95%CI = -0.69, -0.59; p &lt; 0.01), and remained lower during pre-vaccination and vaccination periods. Adherence decreased during pre-vaccination (Coeff = -0.04;95%CI = -0.05, -0.03; p &lt; 0.01) and vaccination periods (Coeff = -0.07;95%CI = -0.08, -0.07; p &lt; 0.01). After the lockdown, there was an increase in any DMT switch (IRR 2.05 95%CI 1.38,3.05; p &lt; 0.01), in switch from platform to highly effective DMTs (IRR 4.45;95%CI 2.48,8.26; p &lt; 0.01) and in first DMT prescriptions (IRR 2.48;95%CI 1.64,3.74; p &lt; 0.01). Conclusions: DMT prescriptions quickly returned to pre-pandemic levels, reflecting good health system recovery. However, adherence has remained lower than the past, as from suboptimal care. Assessing long-term COVID-19 impact on MS healthcare is warranted. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s10072-023-07052-9
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        Text: English
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    Subjects:
      – SubjectFull: Multiple sclerosis
        Type: general
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      – SubjectFull: Medical care
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      – SubjectFull: Patient compliance
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      – SubjectFull: Campania (Italy)
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              Text: Nov2023
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