Multiple Sclerosis in the Campania Region (South Italy): Algorithm Validation and 2015–2017 Prevalence

Abstract

We aim to validate a case-finding algorithm to detect individuals with multiple sclerosis (MS) using routinely collected healthcare data, and to assess the prevalence of MS in the Campania Region (South Italy). To identify individuals with MS living in the Campania Region, we employed an algorithm using different routinely collected healthcare administrative databases (hospital discharges, drug prescriptions, outpatient consultations with payment exemptions), from 1 January 2015 to 31 December 2017. The algorithm was validated towards the clinical registry from the largest regional MS centre (n = 1460). We used the direct method to standardise the prevalence rate and the capture-recapture method to estimate the proportion of undetected cases. The case-finding algorithm including individuals with at least one MS record during the study period captured 5362 MS patients (females = 64.4%; age = 44.6 ± 12.9 years), with 99.0% sensitivity (95% CI = 98.3%, 99.4%). Standardised prevalence rate per 100,000 people was 89.8 (95% CI = 87.4, 92.2) (111.8 for females [95% CI = 108.1, 115.6] and 66.2 for males [95% CI = 63.2, 69.2]). The number of expected MS cases was 2.7% higher than cases we detected. We developed a case-finding algorithm for MS using routinely collected healthcare data from the Campania Region, which was validated towards a clinical dataset, with high sensitivity and low proportion of undetected cases. Our prevalence estimates are in line with those reported by international studies conducted using similar methods. In the future, this cohort could be used for studies with high granularity of clinical, environmental, healthcare resource utilisation, and pharmacoeconomic variables.

Persistence, adherence, healthcare resource utilisation and costs for interferon Beta in multiple sclerosis: a population-based study in the Campania region (southern Italy)

“…Indeed, we included both DMTs and healthcare resource utilisation from routinely collected healthcare data, whilst previous studies mostly focused on DMTs, being the main responsible for direct medical costs, but providing a limited view on MS management [ 4 , 28 – 30 ]. Our case-finding algorithm has 99.0% sensitivity, and is applied on 10% of the Italian population [ 15 ]. Of note, our demographics and Interferon Beta prescription rates are in line with international studies conducted within the same time frame, on equally sized populations [ 26 , 31 – 34 ], thus suggesting overall generalisability of current findings.…”

“…In this population-based study, we performed a retrospective analysis on routinely collected healthcare data, prospectively recorded from 2015 to 2017, on individuals with a diagnosis of MS living in the Campania Region of Italy (representing 10% of the Italian population). The original dataset has been described elsewhere [15].…”

“…Dataset was created by merging different data sources of the Campania Region, as fully described elsewhere [15]. In particular, the cohort comprised all individuals resident in the Campania Region who had at least one MS record, from 2015 to 2017, in the Hospital Discharge Record database, the Regional Drug Prescription database, or the outpatient database with payment exemptions for MS.…”

“…In particular, the cohort comprised all individuals resident in the Campania Region who had at least one MS record, from 2015 to 2017, in the Hospital Discharge Record database, the Regional Drug Prescription database, or the outpatient database with payment exemptions for MS. The case-finding algorithm identified 5362 MS cases, with 99.0% sensitivity [15].…”

COVID-19 prevention and multiple sclerosis management: The SAFE pathway for the post-peak

“…Thus, the curve of the epidemic has been reasonably flat, with less than 5000 cumulative cases in the following two months (by comparison, in a same-sized population, Denmark recorded more than 10,000 cumulative cases) (IHME COVID-19 health service utilization forecasting team, 2020), and the healthcare system has not been overwhelmed by the emergency. In this reasonably-calm scenario, over the past months, MS, infective disease, and public health specialists from the largest centre of the region (Federico II University of Naples, Italy) (Moccia et al, 2020a), have developed (and applied) a protocol for delivering the same quality of services to people with MS, while minimizing the risk of SARS-CoV-2 infection. Thus, our experience will possibly apply to the many countries where the peak of contagion has now passed, but the SARS-CoV-2 is still expected to circulate, at least until a vaccine is available (possibly not earlier than January 2021) and/or herd immunity is achieved (Cohen, 2020).…”