Abstract Details

Title A retrospective evaluation of people with Multiple Sclerosis, to determine factors predicting who declines Disease Modifying Therapies

Topic Multiple Sclerosis

Presentation(s) P12 - Poster Session 12 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-004

Background Since 2001 the Association of British Neurologists have published a series of guidelines to inform which PLwMS should be offered DMTs in the UK and these have formed the core of reimbursement criteria. This study was necessary to gain a greater understanding as to why some PLwMS choose to decline DMT, to determine if there are significant barriers to commencing DMTs.

Objective To identify factors that influence people living with MS (PLwMS), in Greater Manchester, UK, who decline disease modifying therapies (DMTs).

Design/Methods The case notes were reviewed of PLwMS in Greater Manchester, UK, who were never prescribed DMT, in order to assess why they either declined DMTs or were not offered DMTs. Age, gender, ethnicity, age at diagnosis, MS phenotype, index of multiple deprivation based on postcodes at diagnosis and at the time of the study, were gathered for each PLwMS. Fisher’s exact test was used to determine if any of the variables that were tested had a statistically significant impact on the likelihood of declining DMT.

Results Of 988 PLwMS identified, 93% (916/988) were not eligible for DMT under contemporary guidelines. 7% (72/988) declined DMT. Of the patients who declined, the commonest reasons cited were: fear of side effects, concerns surrounding frequent injections and pregnancy. PLwMS from a non-white background were more likely to decline DMTs (p=0.0001). No other factor had a statistically significant impact on a PLwMS declining DMTs.

Conclusions

The majority of the patients who were not receiving a DMT in our service, were not eligible for DMT. Only ethnicity showed a statistically significant impact on the likelihood of PLwMS declining DMT. Further study is required to understand why this is the case and to identify factors to ameliorate this.

Authors/Disclosures
Thomas Jackson PRESENTER	Mr. Jackson has nothing to disclose.
Gagana K. Mallawaarachchi	Mr. Mallawaarachchi has nothing to disclose.
Jack Grimshaw	Mr. Grimshaw has nothing to disclose.
Joyutpal Das, MBBS	Dr. Das has nothing to disclose.
David Rog, MBBS	Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Dr. Rog has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MedDay. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen-Cilag. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Rog has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. The institution of Dr. Rog has received research support from Actelion. The institution of Dr. Rog has received research support from Biogen. The institution of Dr. Rog has received research support from MedDay. The institution of Dr. Rog has received research support from Merck. The institution of Dr. Rog has received research support from Mitsubishi. The institution of Dr. Rog has received research support from Novartis. The institution of an immediate family member of Dr. Rog has received research support from Sanofi Genzyme. The institution of Dr. Rog has received research support from TG Therapeutics. Dr. Rog has received research support from Janssen-Cilag.