Diagnostic delays longer in Hispanic vs. non-Hispanic white patients with MS

Key takeaways:

• Median time from symptom onset to first neurology visit in Hispanic patients was 15 months vs. 2 months for non-Hispanic white patients.
• Median time to diagnosis was 23 months vs. 13 months, respectively.

SAN DIEGO — Delays in visits and diagnosis for multiple sclerosis were longer in a small cohort of Hispanic patients compared with non-Hispanic white patients, according to a poster at the American Academy of Neurology Annual Meeting.
“With this research, we are hoping to clarify diagnostic delays specifically within this population and we’re hoping to increase access in regards to getting timely diagnosis in this population,” Jerusalem Wogayehu, BS, a fourth-year doctoral student at Georgetown University School of Medicine, told Healio. “In addition, [we are] looking at other social and cultural factors that could play into this delayed diagnosis.”

Wogayehu and her colleagues conducted a retrospective study that included 35 individuals of Hispanic descent (mean age, 42 years; 65.7% women) seen at Georgetown MS Center between 2020 and 2023, along with a control group of 35 non-Hispanic white individuals with MS (mean age, 42 years; 65.7% women), selected by birth-year interval, sex and Georgetown neurologist seen.

The researchers conducted phone surveys to collect data such as self-reported race/ethnicity, insurance, time of first symptoms, first neurologist visit and time of MS diagnosis.

Both groups were asked an open-ended question about significant life events that may have led to initial MS symptom onset. These results were subsequently grouped into three categories (environmental, stress/emotions and family history).

Results showed significant gaps between patient groups with respect to elapsed time from symptom onset to disease-related appointments.

The median interval between initial MS symptoms to first neurology visit in the Hispanic population was 15 months, compared with 2 months for non-Hispanic white patients, while the median time from symptom onset to MS diagnosis was 23 months vs. 13 months, respectively.

Data further showed that 14 Hispanic patients with MS logged a wait of fewer than 6 months between symptom onset to first neurological visit and 21 waited 6 months or more vs. 22 and 13 in the control group, respectively.

These delays may be due to less awareness of MS symptoms among these patients, leading to less care-seeking behavior, the researchers said. They also may reflect implicit bias limiting referrals among primary care providers, the researchers added.

Further, the researchers said that these delays could lead to greater risks for morbidity and mortality among these patients.

The researchers additionally reported similarities in perception of MS causes among both surveyed groups, with a majority of Hispanic (n = 17) and non-Hispanic white (n = 18) respondents believing that environmental factors were responsible; conversely, 17 from the Hispanic Georgetown MS group and eight from the control group cited stress/emotions as the main perception, while the split was one and six, respectively regarding family history as MS origin.

The researchers said that their study was limited by both small sample size as well as recall bias, which may explain the lack of statistical significance despite notable disparities.

“I think the biggest thing here is future targeted interventions are needed to address cultural factors within this population,” Wogayehu told Healio, “so that we can better decrease disparities we’re seeing between Hispanic and non-Hispanic white patients.”

For more information:

Jerusalem Wogayehu, BS, can be reached at neurology@healio.com.