Understanding progression in multiple sclerosis: analysis of an in-patient admissions audit

Analysis of in-patient data is valuable to reduce avoidable admissions, which are disruptive to patients and costly to the NHS. The audit aimed to identify causes of in-patient admissions of people with multiple sclerosis at a district general hospital. The audit comprised a retrospective evaluation of secondary in-patient admissions data. Primary causes of admissions included chest infections, falls and urinary tract infections. Secondary progressive multiple sclerosis accounted for the largest number of admissions by multiple sclerosis sub-type, disproportionate to representation on the multiple sclerosis nurse caseload. In contrast, primary progressive multiple sclerosis was represented proportionally. Given the crossover between the two sub-types, this paper explores potential reasons for disproportionate representation by sub-type. Several factors may contribute to the admissions data by sub-type, including patient understandings of progression and information provided by clinicians. These findings have implications for the information and support provided by multiple sclerosis services.