Women with multiple sclerosis and low mobility receive less preventive services

October 25, 2001

Mobility impairments and use of preventive services in women with multiple sclerosis: observational study BMJ Volume 323, pp 968-9 Editorial: Meeting the needs of the chronically ill BMJ Volume 323, pp 945-6

Women with multiple sclerosis and considerable disability are less likely to receive appropriate preventive care than those with less disability, despite their undiminished life expectancy, concludes a study in this week's BMJ.

Researchers in the United States collected self-reported rates of preventive care (such as cervical smear testing, mammography, blood pressure checks and cholesterol screening) for 713 women with multiple sclerosis. They assessed these rates according to the patient's mobility level and compared them with Healthy People 2000 recommendations.

Although rates for general preventive services did not differ by mobility, women with severe mobility impairments were almost five times as likely not to have a cervical smear test, three times as likely not to have a breast examination, and three times as likely not to have mammography compared to fully mobile women.

There are several possible explanations for these findings, say the authors. For instance, patients may be reluctant to undergo screening services that are potentially uncomfortable and embarrassing. Alternatively, the medical systems cannot easily accommodate patients with mobility impairments, who may require access to specialised equipment and extra time.

Women with impaired mobility should be considered a vulnerable population for receipt of breast examinations, mammography and cervical smear tests, say the authors. Studies are needed to identify factors causing this and to evaluate interventions to reduce the variation across mobility levels, they conclude.
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BMJ

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