Disparities in the management of multiple sclerosis–related bladder symptoms
Citation Manager Formats
Make Comment
See Comments

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Background: Participants enrolled in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry report disability status using Performance Scales (PS), a self-report measure. The bladder/bowel subscale (PSB) of PS has not been validated. It is also unknown whether ethnic or socioeconomic disparities exist in bladder care.
Objective: We aimed to validate the bladder/bowel subscale used by the NARCOMS registry and to describe urologic symptoms, investigations, and treatments received by registry participants.
Methods: In the Fall 2005 update questionnaire, we collected the Bowel Control Scale (BWCS) and Urogenital Distress Inventory-6 (UDI-6) as criterion measures and urologic investigations and treatments. We measured associations between investigations, treatments, and symptoms with clinical and sociodemographic variables using χ2 tests for categorical variables and Kruskal–Wallis tests for continuous variables, followed by multivariable logistic regression.
Results: Nine thousand six hundred eighty-eight participants completed the survey. For the UDI-6, the median (interquartile range) score was 33.3 (16.7 to 50.0), for the BWCS 3 (1 to 6), and for the PSB 1 (1 to 3). The correlation between the PSB and the UDI-6 was r = 0.67 and between the PSB and the BWCS r = 0.53 (both p < 0.0001). Participants had increased odds of receiving medication for bladder symptoms if they had health insurance (odds ratio [OR] 1.90; 1.07 to 3.35). Participants who were white (OR 1.5; 1.16 to 1.94) and had health insurance (OR 2.0; 1.3 to 3.07) had increased odds of undergoing urologic investigations.
Conclusion: The Performance Scales bladder question has adequate criterion and construct validity in multiple sclerosis (MS). There are ethnic and socioeconomic disparities in bladder management in MS.
Footnotes
-
Supplemental data at www.neurology.org
Supported in part by the NIH, National Institute of Child Health and Human Development, and Multidisciplinary Clinical Research Career Development Program grant K12 HD04909. The NARCOMS registry receives support from the Consortium of Multiple Sclerosis Centers.
Disclosure: Although no funding was obtained for this specific study, it addresses issues in multiple sclerosis. Ruth Ann Marrie has received support from NIH, the Consortium of Multiple Sclerosis Centers, and the NMSS. Gary Cutter participated in Data and Safety Monitoring Committees for Sanofi-Aventis, Acorda Pharmaceuticals, Bayhill Pharmaceuticals Inc., BioMS Pharmaceuticals, Centocor, Glaxo Pharmaceuticals, Glycomids Pharmaceuticals, Incyte Pharmaceuticals, Millennium Pharmaceuticals, Neurocrine Pharmaceuticals, Protein Design Labs, NHLBI, NINDS, and the NMSS. He has served as consultant to Millenium Pharmaceuticals, Androclus Pharmaceuticals, Consortium of MS Centers, MS-CORE and NMS-funded research group, Practice Based Research Network NYU, and Klein–Buendel Incorporated. Tuula Tyry has served as consultant to Serono and owns shares in Biogen Idec. Timothy Vollmer has received support from NIH/NINDS U01NS45719-01A1, NIH ITN020AI, Abbott, Acorda, Bayhill Therapeutics Inc., Biogen Idec, Genetech, Protein Design Laboratory, Serono, Pfizer, Teva Neurosciences, Novartis, and Berlex. He has served as a consultant for Acorda Therapeutics, Aventis Pharmaceuticals, Inc., Bayer, Bayhill Therapeutics, Inc., Berlex Laboratories, Bristol–Myers Squibb, Centocor, Eisai Medical Research Inc., Genentech, INC Research, Merck Research Laboratories, Neurocrine Biosciences, PRA International, Protein Design Labs, Inc., Schering, and Scirex Corporation. He has served on the speaker's bureau for Serono and Teva Neurosciences. Denise Campagnolo is a consultant for ALZA and has served on the speaker's bureau for Biogen Idec.
Received October 9, 2006. Accepted in final form February 2, 2007.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Disputes & Debates: Rapid online correspondence
NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.
- Stay timely. Submit only on articles published within the last 8 weeks.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- 200 words maximum.
- 5 references maximum. Reference 1 must be the article on which you are commenting.
- 5 authors maximum. Exception: replies can include all original authors of the article.
- Submitted comments are subject to editing and editor review prior to posting.