Olga A Klein1, Roshan das Nair2,3, Joanne Ablewhite1, Avril Drummond1. 1. School of Health Sciences, University of Nottingham, Nottingham, UK. 2. Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK. 3. Institute of Mental Health, Nottingham, UK.
Abstract
BACKGROUND: People diagnosed with multiple sclerosis often have cognitive problems. However, it is unclear how cognitive impairment is currently assessed and managed in the UK. AIM: The aim of this study was to understand the current clinical practice of assessment and management of cognitive impairment in people with MS and to highlight any national variation. METHODS: A survey was posted to 150 MS centres and large hospitals and an online version was shared via email and on social media. RESULTS: Responses were analysed from 109 healthcare professionals. Approximately 59% (n = 64) reported that they used cognitive assessment tools: the Montreal Cognitive Assessment (MoCA) was the most widely used. Assessments were usually done by occupational therapists (55%; n = 60) or clinical neuropsychologist and psychologists (38%; n = 41); 49% (n = 53) of respondents developed and implemented a cognitive rehabilitation plan when the assessment indicated that patients had cognitive problems; 16% (n = 17) indicated that they would refer patients to specialist cognitive rehabilitation for symptom management; 3% (n = 3) followed a manual when providing a cognitive rehabilitation programme. CONCLUSIONS: Clinical pathways for assessing and managing cognitive problems vary and are dependent on the individual expertise of health professionals, available resources, and access to specialist services. Although healthcare professionals highlight the importance of assessment and management, cognitive rehabilitation programmes are not routinely offered in the UK.
BACKGROUND:People diagnosed with multiple sclerosis often have cognitive problems. However, it is unclear how cognitive impairment is currently assessed and managed in the UK. AIM: The aim of this study was to understand the current clinical practice of assessment and management of cognitive impairment in people with MS and to highlight any national variation. METHODS: A survey was posted to 150 MS centres and large hospitals and an online version was shared via email and on social media. RESULTS: Responses were analysed from 109 healthcare professionals. Approximately 59% (n = 64) reported that they used cognitive assessment tools: the Montreal Cognitive Assessment (MoCA) was the most widely used. Assessments were usually done by occupational therapists (55%; n = 60) or clinical neuropsychologist and psychologists (38%; n = 41); 49% (n = 53) of respondents developed and implemented a cognitive rehabilitation plan when the assessment indicated that patients had cognitive problems; 16% (n = 17) indicated that they would refer patients to specialist cognitive rehabilitation for symptom management; 3% (n = 3) followed a manual when providing a cognitive rehabilitation programme. CONCLUSIONS: Clinical pathways for assessing and managing cognitive problems vary and are dependent on the individual expertise of health professionals, available resources, and access to specialist services. Although healthcare professionals highlight the importance of assessment and management, cognitive rehabilitation programmes are not routinely offered in the UK.
Authors: Nadina B Lincoln; Lucy E Bradshaw; Cris S Constantinescu; Florence Day; Avril Er Drummond; Deborah Fitzsimmons; Shaun Harris; Alan A Montgomery; Roshan das Nair Journal: Health Technol Assess Date: 2020-01 Impact factor: 4.014
Authors: Gogem Topcu; Laura Smith; Jacqueline R Mhizha-Murira; Nia Goulden; Zoë Hoare; Avril Drummond; Deborah Fitzsimmons; Nikos Evangelou; Klaus Schmierer; Emma C Tallantyre; Paul Leighton; Kimberley Allen-Philbey; Andrea Stennett; Paul Bradley; Clare Bale; James Turton; Roshan das Nair Journal: Pilot Feasibility Stud Date: 2022-06-11
Authors: Rod M Middleton; Owen R Pearson; Gillian Ingram; Elaine M Craig; William J Rodgers; Hannah Downing-Wood; Joseph Hill; Katherine Tuite-Dalton; Christopher Roberts; Lynne Watson; David V Ford; Richard Nicholas Journal: J Med Internet Res Date: 2020-09-23 Impact factor: 5.428