More MS news articles for Oct 2001

Mobility Impairment in MS Tied to Lower Rate of Gynecologic Preventive Services

WESTPORT, CT (Reuters Health) Oct 26 - Women with multiple sclerosis and impaired mobility are less likely than ambulatory patients to undergo breast examinations, mammography, and cervical smear testing, according to a report in the October 27th issue of the British Medical Journal.

Dr. Eric Cheng, of the University of California in Los Angeles, and associates received questionnaires from 713 women who had received outpatient care in 1993 or 1994. The women's healthcare was covered either by a managed care plan or fee-for-service insurance.

Ambulatory patients were 5.32 times more likely as nonambulatory patients to have had a cervical smear test, 3.62 times more likely to have had a breast examination, and 3.24 times more likely to have undergone mammography (all p < 0.05). Mobility did not affect the rates for blood pressure checks, cholesterol screening, or physician assessment of health habits.

"We don't yet know the reasons for these discrepancies," Dr. Cheng told Reuters Health. "In small qualitative studies, some patients have said that it's too uncomfortable, or too embarrassing because sometimes there has to be a proctor in the room for them to get into certain positions. Those patients need to have the value of these services explained."

He continued, "There's also the issue that some physicians don't realize that these people, even though they have a disability, live just as long as practically everyone else and are just as deserving of the screening processes we offer to the general population. We don't know whether one issue is more important than the other. We do think that eventually both issues need to be addressed."

Guest editorialist Dr. Edward H. Wagner of the Group Health Cooperative of Puget Sound in Seattle notes that "many doctors and practice settings are poorly equipped to care for patients with disabilities and chronic illness."

Dr. Cheng and his colleagues conclude, "Women with impaired mobility should be considered a vulnerable population for receipt of breast examinations, mammography, and cervical smear tests."

BMJ 2001;323:945-946,968-969.

Copyright © 2001 Reuters Ltd