{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:45:23Z","timestamp":1777945523487,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In multiple sclerosis (MS), delays in initiation of disease-modifying therapy (DMT) are associated with worse clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective chart review study included treatment-naive and previously treated people with MS (PwMS) initiated on DMT between 01 September 2021 and 01 September 2023. A generalized linear model was utilized to evaluate associations between start-up times (initial treatment decision to completion of first dose) and distance to the clinic, utilization of the center's infusion center and specialty pharmacy, insurance and educational status, route of administration, race\/ethnicity, and household income.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 116 PwMS were included (median age 41 [15\u201374] years; 87.9% female). Increased geographic distance from the MS center correlated with longer start-up times (&gt;100\u2005km: 76.5 [0\u2013393] days vs. \u2264100\u2005km: 53.5 [2\u2013524] days);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04). People with MS with private insurers had longer start-up times (66 [0\u2013524] vs. 50.5 [0\u2013201] days;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016). The utilization of outside infusion centers and specialty pharmacies delayed initiation (82.5 [0\u2013524] vs. 39.5 [0\u2013372] days;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This small retrospective study demonstrates an association between longer start-up times and greater geographic distance, private insurance status, and use of outside infusion centers and specialty pharmacies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173261447996","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:04:22Z","timestamp":1777554262000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with delays in multiple sclerosis disease-modifying therapy initiation"],"prefix":"10.1177","volume":"12","author":[{"given":"Laura","family":"Snider","sequence":"first","affiliation":[{"name":"University of Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsa","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9482-0653","authenticated-orcid":false,"given":"Hannah","family":"Rains","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Peraza","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayra","family":"Montalvo","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0538-1378","authenticated-orcid":false,"given":"Torge","family":"Rempe","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520970841"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7020-6896-6.00066-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011242"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00577"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012726"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp130495"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458510373487"},{"key":"e_1_3_2_9_2","first-page":"420","article-title":"Effects of specialty pharmacy care on health outcomes in multiple sclerosis","volume":"9","author":"Tang J","year":"2016","unstructured":"Tang J, Bailey J, Chang C, et al. Effects of specialty pharmacy care on health outcomes in multiple sclerosis. Am Health Drug Benefits 2016; 9: 420\u2013429.","journal-title":"Am Health Drug Benefits"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073.2023-039"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013059"},{"key":"e_1_3_2_12_2","unstructured":"Amezcua L. Diagnosing multiple sclerosis in diverse populations and geographies. 2025."},{"key":"e_1_3_2_13_2","unstructured":"Imitola Ja. Disease-modifying therapies and real-world strategies to improve care throughout the lifespan in diverse populations with MS. 2025."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2196\/11168"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-025-01205-4"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562864241233044"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458518809326"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1080\/21556660.2019.1658304"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.9740\/mhc.2021.05.187"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxae024"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073.2022-069"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000927"},{"key":"e_1_3_2_23_2","article-title":"Navigating access and optimizing medication infusions in an academic medical center: a quality improvement study","volume":"11","author":"Jusufi H","year":"2023","unstructured":"Jusufi H, Boivin N. Navigating access and optimizing medication infusions in an academic medical center: a quality improvement study. Pharmacy (Basel) 2023; 4: 11.","journal-title":"Pharmacy (Basel)"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24062"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.1558"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/13524585241289274"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.101930"}],"container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552173261447996","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20552173261447996","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552173261447996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:16:23Z","timestamp":1777724183000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20552173261447996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/20552173261447996"],"URL":"https:\/\/doi.org\/10.1177\/20552173261447996","relation":{},"ISSN":["2055-2173","2055-2173"],"issn-type":[{"value":"2055-2173","type":"print"},{"value":"2055-2173","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"article-number":"20552173261447996"}}