title: The management of multiple sclerosis by reference centers in south of Italy: a 2011 survey on health demands and needs in Campania region.
abstract: This cross-sectional study has investigated the diagnostic and therapeutic management of patients suffering from multiple sclerosis (MS) in the Campania Region (Italy). A survey involving all the reference centers for MS in Campania Region was conducted from March to August 2011. Centers responded to a web-administered questionnaire on management and clinical characteristics of MS patients. In the study period, 3263 patients (mean age 37 years, 66 % females) accessed the centers. Patients received a first diagnosis of MS in 161 cases (4.9 %). About 37 % of the subjects without a previous diagnosis came to the centers on their own initiative. All patients underwent a complete neurological examination and expanded disability status scale. The other most common investigations were magnetic resonance imaging (44.0 %) and evoked potentials (22.1 %). The number of treated patients was 2797 (87.1 %). The most used drugs were interferon β and glatiramer acetate. The time between diagnosis and initiation of therapy exceeded 6 months in 32 % of cases. Second-line drugs were under-used: 16 % of patients who might benefit from them show high clinical and radiological disease activity despite treatment with immunomodulant drugs. The MS care management of the surveyed centers showed consistent margins for improvement in 2011. Even though these data do not represent the current situation, they can be used to monitor improvements in MS care.
authors.affiliation: Institute of Public Health, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: de Waure
authors.affiliation: Institute of Public Health, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168, Rome, Italy. francesco_pope84@hotmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Nardo
authors.affiliation: Department of Sciences for Health Promotion and Mother and Child Health. "G. D'Alessandro", University of Palermo, Palermo, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Mazzucco
authors.affiliation: Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: Darko
authors.initials: D
authors.lastname: Nedovic
authors.affiliation: Fondazione Italiana Sclerosi Multipla, Milan, Italy.
authors.forename: Mario Alberto
authors.initials: MA
authors.lastname: Battaglia
authors.affiliation: Maria SS Addolorata Hospital, Eboli, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Busillo
authors.affiliation: P. Rummo Hospital, Benevento, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Di Iorio
authors.affiliation: Second University of Naples, Caserta, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
authors.affiliation: University of Naples Federico II, Naples, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Lanzillo
authors.affiliation: Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Lombardi
authors.affiliation: Cardarelli Hospital, Naples, Italy.
authors.forename: Giorgia Teresa
authors.initials: GT
authors.lastname: Maniscalco
authors.affiliation: University of Naples Federico II, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orefice
authors.affiliation: University of Naples Federico II, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Petracca
authors.affiliation: CTO Hospital-AORN Ospedali dei Colli, Naples, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Romano
authors.affiliation: ASL Napoli 1 Centro, San Paolo Hospital, Naples, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sinisi
authors.affiliation: Second University of Naples, Caserta, Italy.
authors.forename: Anna Pia
authors.initials: AP
authors.lastname: Spadera
authors.affiliation: San Moscati Hospital, Avellino, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Spitaleri
authors.affiliation: Moscati Hospital, Aversa, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vivo
authors.affiliation: Institute of Public Health, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168, Rome, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000628:therapy*; D020380:Needs Assessment; D011795:Surveys and Questionnaires
keywords: Disease management; Health services needs and demand; Multiple sclerosis