P45 Predictors of Patient Management Attributes in Pediatric Multiple Sclerosis

Saturday, June 1, 2013
Sabeen Lulu, MD , Neurology, University of California, San Francisco, San Francisco, CA
Laura Julian, PhD , University of California, San Francisco, San Francisco, CA
Emma Shapiro, BA , Psychology, Pacific Graduate School of Psychology, Hayward, CA
Emmanuelle Waubant, MD, PhD , Neurology, University of California, San Francisco, San Francisco, CA

Background: 5% of individuals with MS have an onset of disease before 18 years of age. Those patients are placed on disease modifying therapies approved for adults. Adherence to these therapies is understudied in this age group. Patients face disability and an impact of MS on their quality of life and functional outcomes for a much longer period of time. It is unknown what factors place children and adolescents at increased vulnerability for poor health outcomes.

Objectives: To study the predictors of patient management attributes, social and behavioral determinants of poor health outcomes in pediatric multiple sclerosis (MS).

Methods: Patients included are from the UCSF regional pediatric MS center and transition clinic. This is a cross sectional study with validated questionnaires on quality of life (QOL), brief illness perception questionnaire, and transition readiness assessment questionnaire (TRAQ) from the patient and one of the parents. Clinical data are collected at the time of the patient’s visit to our center. Study is still ongoing with a goal of enrolling 56 patients.

Results: Preliminary data with 33% enrollment included equal numbers of male and female patients.  Mean age was 16.7 years (range 14 –23) . 20%, 50% and 30% of the families included were of low, middle and high socioeconomic status (SES) respectively. Median expanded disability status scale was 1.5 (range 0 – 3.5). Disease-modifying therapy used was weekly interferon beta-1a in 40%, three times weekly interferon beta-1a in 10%, glatiramer acetate in 30% and others in 20%. There was a weak positive correlation between SES and TRAQ scores with self-management attributes. There was no difference between patient and parent QOL scores for both physical and psychosocial assessments (p=0.16 and p=0.22 respectively). Data for relapse rate corresponding to patient adherence and neuropsychiatric evaluations are still pending analysis.

Conclusions: Identifying social and behavioral determinants of health outcomes in pediatric MS patients will contribute to improve treatment of MS patients in the pediatric population.