To measure the value of implementation of a myasthenia gravis specialty clinic in a safety-net hospital setting.

Myasthenia gravis (MG) patients in the Parkland Hospital Health System in Dallas, TX are a high-risk population with historically poor follow-up rates, high symptom burden, and high exacerbation rates. An MG specialty clinic operated by a neuromuscular expert was created to address the needs of this underserved population, improve show-rates, and reduce MG-related hospitalizations  

A retrospective analysis of MG patients enrolled in the Parkland Hospital MG specialty clinic between July 2021 - July 2023 was performed. Enrollment was defined as attending > 2 clinic visits. The show rate and Myasthenia Gravis Activities of Daily Living (MG-ADL) score trends after enrollment were analyzed. Of patients enrolled in the MG clinic, individuals previously followed in the neurology clinic were identified. The frequencies of MG-related hospitalizations in this cohort were compared before and after enrollment.

Over the first two years since inception, 61 patients were established in the MG specialty clinic (mean age 51.7, 57.6% Hispanic, 22% Black, 3.6% Asian with 78% community or government funded). The show rate across 366 clinic visits was 82%. MG-ADL score across these visits revealed a decreasing trend. The patients that were also followed prior to the creation of the clinic (n=34) were found to have a significant decrease (p<0.05) in MG-related hospital admission rates after establishing in the specialty clinic. Patients that were established in the specialty clinic without prior following in our center had similar hospitalization rates as the post-intervention cohort.  

Establishment of an MG specialty clinic in a safety-net hospital can lead to improved show rates, reduced rates of hospitalizations, improved MG-ADL scores, and overall improvement in quality of life in patients with MG.