Neurologist Versus Nonneurologist Care of Multiple Sclerosis Patients

The purpose of this study was to identify differences between people with multiple sclerosis (MS) who are treated by someone other than a neurologist and those treated by neurologists or specialists at MS clinics. Factors studied included demographics, disease characteristics, and patient perceptions of care. We surveyed 1518 people with MS, organizing respondents into four groups based on who provided their care: a nonneurologist group, two neurologist groups, and an MS clinic group. We analyzed survey results via SPSS, using analysis of variance to identify statistically significant differences. The nonneurologist group was significantly older, had lower income, and had more patients without health insurance than the other three groups. This group was also significantly less satisfied with access to MS-focused care and the quality of that care. The most striking observation was the significantly smaller proportion (18%) of people in the nonneurologist group who were treated with disease-modifying therapies compared with the other three groups (67–72%). Significant and interesting differences were observed for a range of characteristics between the nonneurologist group and groups receiving care from neurologists or at an MS clinic. A carefully constructed outreach program for nonneurologists is suggested as a way of increasing the use of MS therapies.