Background: MS-CQI was the first multi-center improvement research collaborative for people with multiple sclerosis (MS) and was a three year study of system-level variation and use quality improvement (QI) methods to improve MS outcomes (2017-2020). Assessing Patient Reported Outcomes (PROs), such as satisfaction to medication treatment, is important in complex, chronic, and costly (“3C”) diseases like MS where people with MS (PwMS) commonly suffer from mental health problems that impact quality of life (QoL) and MS related outcomes.

Objectives: To describe center-level variation in TSQM-9 scores across four MS centers over a three-year period.

Methods: TSQM surveys were collected from 327 adults aged >18 years participating in this study. TSQM surveys are included in the MS-CQI study to assess PwMS satisfaction to treatment in 3 key dimensions including: medication effectiveness, convenience and global satisfaction. Descriptive statistics were evaluated for each center, as well as significance testing across and between centers. Continuous variables were analyzed using ANOVA, and categorical variables were analyzed using Chi-Square tests.

Results: We observed statistically significant differences in center level variation among the convenience (p=0.0483) and global satisfaction (p=0.0168) domains of the TSQM-9 survey. Post-hoc analysis showed a statistically significant difference for the convenience domain a rural hospital (center A), and urban academic hospital (center B), (p<0.05) with center A having a mean score of 8.403 higher than center B. Females scored higher than males (75.56 vs. 72.80, respectively) in the global satisfaction domain of the TSQM surveys (p=0.0457). Other variance in domains include marital status and survey responses for effectiveness of their medication treatment (p=0.0301) with those who were married scoring higher in this domain compared to those that were single or divorced.

Conclusion: Further research should analyze the association between treatment satisfaction and geographic variation to optimize medication therapy management and reduce inequities for PwMS.