The Montenegrin Health care system is trying to provide high level of care to multiple sclerosis (MS) patients, which is followed by their better quality of life (QoL), better mental health, ability to participate and enjoy in social activities and positive mindset and attitude. Since 2017 number of treated patients has been increased from 16% to 61% due to improved access to DMTs. The important question remains whether there could be an improvement in QoL by allowing patients to start the treatment with DMT right after the MS diagnosis.
Objective of the study was to assess the impact of time distance between diagnosis of MS and beginning of the treatment on the quality of life of MS patients in Montenegro.
The analysis was based on data collected from questionnaires and two focus groups with the patients. Questionnaires were filled by 138 patients who started the treatment within the time frame shorter than two years after the diagnosis of MS and 81 patients who started the treatment after more than two years. Four indicators were used in the analysis: RAND 36-Item Health Survey (SF-36), MOS Pain Effects Scale (PES), Impact of Visual Impairment Scale (IVIS) and Perceived Deficits Questionnaire (PDQ).
SF-36 indicator shows that patients with earlier access to treatment rate their health, on average, with 30% higher rank than the patients who started treatment later. Earlier access to therapy made patients feel like their health has improved during the past year, or remained the same, while the patients that received later access to treatment considered their health as worse than before. PES shows that pain and unpleasant sensations caused by MS have 14% more negative impact on quality of life of patients that accessed the therapy later. The result of IVIS suggests that the impact of visual problems caused by MS on everyday activities is almost 60% higher among patients with later access to the therapy. PDQ suggests that cognitive functioning is 32% more affected by MS when the patient receive the first therapy after more than two years after the diagnosis.
Conclusion of the study is that, by approving early MS treatment to patients in the period of time not longer than two years from the diagnosis, positive effect would be felt in every aspect of the patients’ quality of life. The results were further reinforced by the findings from the focus groups, where the respondents emphasized that timely access to adequate therapy enabled them to preserve their QoL. This was the first of a kind research in Montenegro and these national data will be strong recommendation towards promoting benefits of early MS treatment.