BACKGROUND: People with multiple sclerosis (MS) are at increased risk for cognitive impairment, mental health concerns, and psychosocial issues, which can negatively affect disease outcomes and quality of life. Current MS care guidelines recommend integrated interdisciplinary services to address these concerns; however, issues can be overlooked during routine care. To date, there is inadequate research on how often these issues are identified and addressed during routine MS care. METHODS: One hundred medical records were randomly selected and reviewed (55 relapsing-remitting MS, 17 secondary progressive MS, 8 primary progressive MS, and 20 other or subtype not indicated). All visits to, and contacts with (ie, telephone, e-mail), an MS clinic over 1 year were included in the analysis to determine the proportion of patients presenting with cognitive, mental health, and psychosocial concerns and the proportion of patients offered associated services. RESULTS: Of the 25 patients with at least one identified concern, treatment recommendations occurred for 13 (52%). Rates of identification of cognitive, mental health, and psychosocial concerns in standard clinical practice were significantly lower than the identified prevalence in epidemiologic studies. Demographic factors had no bearing on who was offered treatment. Patients with concerns access MS clinic services more often than those without. CONCLUSIONS: Discrepancies between reported and expected frequencies may be due to overreliance on patient self-disclosure and concerns by the health care team that inadequate resources are available to address issues. An interdisciplinary team model may help address these issues.
BACKGROUND: People with multiple sclerosis (MS) are at increased risk for cognitive impairment, mental health concerns, and psychosocial issues, which can negatively affect disease outcomes and quality of life. Current MS care guidelines recommend integrated interdisciplinary services to address these concerns; however, issues can be overlooked during routine care. To date, there is inadequate research on how often these issues are identified and addressed during routine MS care. METHODS: One hundred medical records were randomly selected and reviewed (55 relapsing-remitting MS, 17 secondary progressive MS, 8 primary progressive MS, and 20 other or subtype not indicated). All visits to, and contacts with (ie, telephone, e-mail), an MS clinic over 1 year were included in the analysis to determine the proportion of patients presenting with cognitive, mental health, and psychosocial concerns and the proportion of patients offered associated services. RESULTS: Of the 25 patients with at least one identified concern, treatment recommendations occurred for 13 (52%). Rates of identification of cognitive, mental health, and psychosocial concerns in standard clinical practice were significantly lower than the identified prevalence in epidemiologic studies. Demographic factors had no bearing on who was offered treatment. Patients with concerns access MS clinic services more often than those without. CONCLUSIONS: Discrepancies between reported and expected frequencies may be due to overreliance on patient self-disclosure and concerns by the health care team that inadequate resources are available to address issues. An interdisciplinary team model may help address these issues.
Authors: Scott B Patten; Jodie M Burton; Kirsten M Fiest; Samuel Wiebe; Andrew G M Bulloch; Marcus Koch; Keith S Dobson; Luanne M Metz; Colleen J Maxwell; Nathalie Jetté Journal: Mult Scler Date: 2015-01-12 Impact factor: 6.312
Authors: S Clement; O Schauman; T Graham; F Maggioni; S Evans-Lacko; N Bezborodovs; C Morgan; N Rüsch; J S L Brown; G Thornicroft Journal: Psychol Med Date: 2014-02-26 Impact factor: 7.723
Authors: Ralph H B Benedict; Maria Pia Amato; Jan Boringa; Bruno Brochet; Fred Foley; Stan Fredrikson; Paivi Hamalainen; Hans Hartung; Lauren Krupp; Iris Penner; Anthony T Reder; Dawn Langdon Journal: BMC Neurol Date: 2012-07-16 Impact factor: 2.474