Assessment of compliance and patient pathway among multiple sclerosis patients on disease modifying treatment

Background and purpose - Epidemiological data and the number of patients treated suggest that the proportion of Hungarian patients with Multiple Sclerosis (MS) receiving disease-modifying therapy (DMT) is lower than in some neighboring countries. We investigated possible reasons for this. Methods - First we analysed patient compliance based on an anonymised database of the National Health Insurance Fund (NHIF). A total of 5441 patients were included in the analysis from NHIF prescription data from 1 July 2014 to 28 February 2021. In the second part of the study, a quantitative and qualitative assessment of patient journeys of MS patients was conducted. Results - The compliance of Hungarian MS patients is good compared to international MS treatment data and outstanding compared to other neurological and other diseases, e.g. cardiovascular. This cannot be said about the results of the patient pathway analysis based on patient interviews. Patients indicated that they often have difficulty accessing public health care. Tracing their pathways revealed that they needed to see 3-5 doctors (general practitioner, various specialists) before a diagnosis was made. However, they gave positive feedback about MS Centres. They trusted their doctors, found them empathetic, but they would have liked more time to discuss lifestyle issues. Conclusion - Compared to some neighbouring countries, Hungary has a lower proportion of patients with treated MS, which, given the good compliance of patients, highlights the problem of patient path in Hungary. Further training of fellow physicians is also a task for neurologists specialising in MS. Just as the most common symptoms of stroke have been successfully introduced into the public consciousness, the same can be the aim for MS.