Clinical Centre of Montenegro
Department of Neurology

Author Of 3 Presentations

Epidemiology Poster Presentation

LB1147 - Multivitamin, Vitamin C and Vitamin D Pills Self-Medication in Multiple Sclerosis Patients in Montenegro During COVID-19 Pandemic (ID 428)

Speakers
Presentation Number
LB1147
Presentation Topic
Epidemiology

Abstract

Background

The recent COVID-19 pandemic has shaken all countries of the world, and especially their health systems. In the days of fear and uncertainty, many chronic patients, including patients with multiple sclerosis (MS), began to use vitamin supplements in order to strengthen immunity and protect against the new SARS-Cov2 virus.

Objectives

The aim of our study was to determine how the COVID-19 epidemic in Montenegro, a small Balkan country with 631.219 inhabitants, affected the intake of vitamin preparations in patients with MS.

Methods

The research was conducted through an online-generated questionnaire during the days with the highest number of virus cases in Montenegro.

Results

In total, we received 101 responses (response rate was 77.7%). The sample was composed of 25 male (24.7%) and 76 female (75.3%) patients with mean age of 39.4±8.7 years. In our group, 40 patients (39.6%), due to the COVID-19 epidemic, started taking vitamin C preparations, and among them there were statistically more males, and it was noticed that as the age of patients and the duration of the disease increased the frequency of taking vitamin C preparations is also growing. The largest number of our respondents (78, ie 77.2%) used vitamin D supplements during the epidemic, but the largest number of them (73, ie 72.3%) used it even before the epidemic outbreak. The group that does not use vitamin D preparations is statistically younger than the population that uses them. Regarding multivitamin preparations, due to the epidemic of the new virus 33 of our respondents (32.7%) started using them, and among them there are statistically more males, as well as those living in the regions of Montenegro that were affected by the COVID-19 epidemic. The group that does not use multivitamin preparations is less afraid for the further course of their disease and believes that there is a lower risk of getting SARS-Cov2 virus.

Conclusions

The recent COVID-19 epidemic has influenced MS patients from Montenegro to intensify their intake of vitamin preparations in order to strengthen immunity and prevent SARS-Cov2 infection.

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Prognostic Factors Poster Presentation

P0453 - Diagnosis- to-Treatment Interval Has Implication on Quality of Life of patients with Multiple Sclerosis in Montenegro. (ID 1192)

Speakers
Presentation Number
P0453
Presentation Topic
Prognostic Factors

Abstract

Background

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.

Objectives

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.

Methods

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).

Results

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.

Conclusions

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.

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Prognostic Factors Poster Presentation

P0454 - Diagnosis-to-Treatment Interval Is an Important Factor on the Productivity of  Multiple Sclerosis patients in Montenegro. (ID 1189)

Speakers
Presentation Number
P0454
Presentation Topic
Prognostic Factors

Abstract

Background

Number of multiple sclerosis (MS) patients in Montenegro amounts to 650, with 61% of them receiving disease modifying therapy (DMT). Since 2017 number of treated patients has been increased from 16% to 61% due to improved access to DMTs. When patients diagnosed with secondary progressive form of MS, for which there is no approved therapy in Montenegro, and patients with a primary progressive form of MS who are already in an advanced stage of the disease (EDSS >7) are excluded from the total number, so all MS patients in Montenegro who need DMT have access to it.

Objectives

Since the access to adequate treatment is not questionable in Montenegro, the objective of the study was to identify the importance of early access to DMT.

Methods

The analysis was based on data collected from questionnaires filled by 138 patients who started the treatment after less than two years upon the diagnosis of MS and 81 patients who started the treatment after more than two years, or who do not receive therapy, as well as on data collected during two focus groups with the patients. We have used three indicators that measure work ability and productivity: two monetized – Productivity and Disease Questionnaire (PRODISQ) and Work Productivity and Activity Impairment Questionnaire: Multiple Sclerosis V2.1 (WPAI:MS), and one non-monetized – The Health and Work Performance Questionnaire (HPQ).

Results

The results of PRODISQ suggest that the average annual loss caused by decreased productivity per MS patient in Montenegro is 35% higher in situation when patients received their treatment after more than two years after the diagnosis. Total cost of decreased productivity of MS patients in Montenegro is approximately 1 million EUR per annum, equivalent to 27,160 working days per annum. WPAI:MS suggests that the average annual cost of absenteeism per patient who received the therapy later is 2.3 times higher than it is for a patient recieved earlier. Total cost of absenteeism of MS patients in Montenegro is approximately 190 thousand EUR per annum. HPQ analysis suggests that the patients with earlier access to therapy are on average three times less absent from work. It also shows that, by the subjective feelings of patients, productivity is similar, or even higher than the average productivity of other employees with similar job, if the patient had earlier access to therapy, and lower than the average, it he/she didn’t.

Conclusions

Earlier access to MS therapy provided to greater number of patients would result in significant reduction of lost productivity costs in Montenegro. 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 working productivity. This was the first of a kind research in Montenegro and these national data will be strong recommendation towards promoting economic benefits of early MS treatment for the patients and for the Healthcare system as well.

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