Jordi Gol University Institute for Research in Primary Care
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Comorbidities Poster Presentation

P0474 - MS is associated with higher comorbidity, adverse health behaviors, and healthcare resource usage: population based case-control study in Catalonia. (ID 567)

Presentation Number
P0474
Presentation Topic
Comorbidities

Abstract

Background

Comorbidities and adverse health behaviors are associated with worse outcomes in multiple sclerosis (MS) and increased use of healthcare resources. Some comorbid conditions are more frequent in MS compared to the general population. The frequency and impact of comorbidities in our region is unknown.

Objectives

Describe the frequency of common comorbidities, adverse health behaviors, and healthcare resource usage in MS patients compared to the general population in Catalonia.

Methods

This is a population-based case-control study of the primary healthcare information system that covers 80% of the population of Catalonia. Cases were identified using the CIE-10 MS code (G35), and age/sex- matched controls (ratio 1:5) were randomly chosen, if they had at least one visit since 2006 and did not have active CIE-10 coding for any demyelinating disease. We obtained information on demographics (age, sex, socioeconomic status), comorbidities (by count and type), adverse health behaviors (smoking, alcohol), annual visits (primary care and specialists), sick leave days and medication dispensing.

Bivariate analysis and adjusted logistic regressions were done and odds ratios (OR) with 95% confidence interval (CI) were calculated.

Results

5548 MS cases and 27710 controls were included. 70% were female and mean age was 48.3 years. A total of 3334 (60.1%) of cases vs. 15756 (56.8%) of controls had at least one comorbidity (p<0.001). A higher frequency of comorbidities was found in MS in the 20-39 (OR: 1.377; 95%CI: 1.229-1.542) and 40-59 (OR: 1.231; 95%CI: 1.135-1.336) age ranges, whereas it was lower in 60-79 (OR: 0.648; 95%CI: 0.551-0.763) and >80 years (OR: 0.268; 95%CI: 0.115-0.625) age ranges. Socioeconomic deprivation was associated with a higher presence of comorbidities in MS cases (OR: 1.456; 95%CI: 1.161-1.824). Stroke (OR: 1.513; 95%CI: 1.173-1.952) and epilepsy (OR 2.566; 95%CI: 2.034-3.237), as well as any psychiatric disorder (OR 1.425; 95%CI: 1.377-1.519), bipolar disorder (OR: 1.882 95%CI: 1.335-2.654), or major depression (OR: 1.791: 95%CI 1.660-1.932) were more frequent in MS. Cardiovascular diseases were more frequent in males, whereas psychiatric diseases were more frequent in females. MS cases had higher annual sick leave days (11 vs. 6.7; p<0.001) and nurse (3 vs. 1.7; p<0.001), primary care (5 vs. 3.8; p<0.001) and specialist visits (11.9 vs. 0.5; p<0.001), as well as yearly medication dispensing. MS patients were more prone to smoking but not to alcohol consumption, especially among males.

Conclusions

MS patients have higher risk of psychiatric comorbidities, stroke and epilepsy, as well as adverse health behaviors and higher healthcare resource usage than the general population. The profile of comorbidities differs between women and men. Comorbidities are more frequent in the mos deprived socioeconomic strata.

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