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Epidemiology Poster Presentation

P0459 - Factors associated with access to disability certificate in patients with MS and NMOSD in Argentina (ID 1156)

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Disability certificate (DC) is a free public document valid throughout Argentina. DC offers economic and social benefits to people with disabilities and improves barriers to accessing health services. Multiple sclerosis (MS) and neuromyelitis optic spectrum diseases (NMSD) are disabling diseases that affect economically active people.


To analyze access to DC in patients with MS (PwMS) and NMOSD (PwNMOSD) in patients included in the Argentinean MS and NMOSD registry (RelevarEM, NCT 03375177).


Demographical, clinical and social data from RelevarEM were analyzed. Parametric and nonparametric statistics were performed, to define significance a p value <0.05 was accepted.


2979 patients were included (2814 MS and 165 NMOSD). For PwMS 80.7% were relapsing remitting MS, female 65.2%, mean age 43.5±12.9 years, mean EDSS 2.8, mean disease evolution 10.8±8.9 years, 33.9% unemployed and 43.1% had DS. For PwNMOSD 77% were female, mean age 44.7 ± 14.8 years, mean EDSS 3.3 mean disease evolution 7.3±5.9 years, 43.6% unemployed and 41.2% had DC. Overall, 11.8% of patients had public health insurance. When comparing the demographic and clinical variables of PwMS and PwNMOSD between those with and without DC, statistically significant differences were found (p≤0.05). For PwMS Multivariate analysis showed that EDSS (OR=1.60, p<0.01), time to treatment (OR=1.06, p=0.01), comorbidity index (OR=3.19, p<0.01), place of residence (OR=0.66, p<0.01), healthcare insurance (OR=1.36, p=0.02), and employment status (OR=0.41, p<0.01) were independently associated with access to DC. In PwNMOSD it was associated with EDSS (OR=1.57, p<0.01), place of residence (OR=0.34, p=0.03), healthcare insurance (OR=5.72, p=0.01), and employment status (OR=0.22, p=0.01)


this research is the largest to explore DC access and related factors in Argentinian PwMS and PwNMOSD. Future research should explore which factors affect the decisions of individuals to seek DC and how neurologists can assist in that process.