Abstract Details

Title NMOSD Patients Transitioning from Adolescent to Adult Care: A Multi-institutional Database Analysis in the United States

Topic Autoimmune Neurology

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-019

Objective

Describe population healthcare utilization trends and identify potential barriers and social determinants of health in a national cohort of young patients with NMOSD.

Background

Neuromyelitis Optica Spectrum Disorder (NMOSD) is a chronic, relapsing autoimmune disease primarily affecting the spinal cord and optic nerves. Patients may have significant accrual of neurologic disability with initial and subsequent attacks, making consistent long-term use of disease modifying therapies essential. There is little research on barriers that adolescent NMOSD patients experience when transitioning from pediatric to adult healthcare. Understanding social factors that place patients at highest risk for gaps in treatment is essential for successful transitions of care in this population.

Design/Methods

Deidentified aggregate data was obtained from TriNetX, a health research network providing access to electronic medical records that includes sixty-one healthcare organizations in the US. Patients with at least three visits coded with the ICD-10 code of NMO (G36.0) were queried within the database between 2008-2023. Data on healthcare utilization and demographic information were extracted for analysis.

Results

7,657 unique patients with NMOSD were identified in the TriNetX database and stratified into age groups to identify 193 patients in the 11 to 17 age group, 437 in the 18 to 25 age group, and 541 in the 26 to 31 age group. Within these three age groups, 71% (n=833) were female, 52% (n=606) identified as white, and 26% (n=3070) identified as black. We report here on the specific treatment gaps identified in this population.

Conclusions

Given that young adults often experience insurance changes, relocations, and changes in providers as they move from adolescence to adulthood, they represent a group vulnerable to significant barriers and inequities in healthcare utilization. Identification of the specific challenges and social determinants of health which may place patients at high-risk for inconsistent treatment is essential to effect change aimed at optimizing long-term outcomes.

Authors/Disclosures
Melissa A. Wright, MD (University of Utah) PRESENTER	Dr. Wright has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis .
Ka-Ho Wong (U of U Neurology Clinic)	The institution of Mr. Wong has received research support from The Sumaira Foundation . The institution of Mr. Wong has received research support from The Siegel Rare Neuroimmune Association.
Trieste Francis	Miss Francis has nothing to disclose.
Abigail H. Sorenson	Ms. Sorenson has nothing to disclose.
John W. Rose, MD, FAAN (Imaging and Neurosciences Center)	The institution of Dr. Rose has received research support from National Multiple Sclerosis Society. The institution of Dr. Rose has received research support from Guthy Jackson Charitable Foundation. The institution of Dr. Rose has received research support from NIH . The institution of Dr. Rose has received research support from VA. The institution of Dr. Rose has received research support from Biogen. The institution of Dr. Rose has received research support from Friends of MS. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care.
Tammy L. Smith, MD, PhD (Imaging and Neurosciences Center)	Dr. Smith has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. Smith has received research support from Alexion/AstraZeneca.
Stacey Clardy, MD, PhD, FAAN (University of Utah)	Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Beaumont Health, CCF, Emory, Penn State, Mayo Clinic, Walter Reed.

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