Primary Care for the Multiple Sclerosis Patient

2020 ◽  
Vol 8 (11) ◽  
Author(s):  
Vijay Aswani

Multiple sclerosis is the commonest non-traumatic disabling disease that affects young adults. The presenting signs and symptoms include several common symptoms seen in primary care. It therefore behooves primary care practitioners to recognize the disease’s presentation, mimicking diagnoses and initial workup. Management of many of the symptoms of disease exacerbations are within the purview of the primary care provider. Co-management of the patient with multiple sclerosis with a neurologist improves patient care and provides a context for management of co-morbidities. The patient-centered medical home provides many services and resources that can be of use to a multiple sclerosis patient. Vaccinations and other preventative care are important in the care of the multiple sclerosis patient, particularly those on immunosuppression therapy for their disease.

2015 ◽  
Vol 7 (4) ◽  
pp. 580-588 ◽  
Author(s):  
Fadya El Rayess ◽  
Roberta Goldman ◽  
Christopher Furey ◽  
Rabin Chandran ◽  
Arnold R. Goldberg ◽  
...  

ABSTRACT Background The patient-centered medical home (PCMH) is an accepted framework for delivering high-quality primary care, prompting many residencies to transform their practices into PCMHs. Few studies have assessed the impact of these changes on residents' and faculty members' PCMH attitudes, knowledge, and skills. The family medicine program at Brown University achieved Level 3 PCMH accreditation in 2010, with training relying primarily on situated learning through immersion in PCMH practice, supplemented by didactics and a few focused clinical activities. Objective To assess PCMH knowledge and attitudes after Level 3 PCMH accreditation and to identify additional educational needs. Methods We used a qualitative approach, with semistructured, individual interviews with 12 of the program's 13 postgraduate year 3 residents and 17 of 19 core faculty. Questions assessed PCMH knowledge, attitudes, and preparedness for practicing, teaching, and leading within a PCMH. Interviews were analyzed using the immersion/crystallization method. Results Residents and faculty generally had positive attitudes toward PCMH. However, many expressed concerns that they lacked specific PCMH knowledge, and felt inadequately prepared to implement PCMH principles into their future practice or teaching. Some exceptions were faculty and resident leaders who were actively involved in the PCMH transformation. Barriers included lack of time and central roles in PCMH activities. Conclusions Practicing in a certified PCMH training program, with passive PCMH roles and supplemental didactics, appears inadequate in preparing residents and faculty for practice or teaching in a PCMH. Purposeful curricular design and evaluation, with faculty development, may be needed to prepare the future leaders of primary care.


2011 ◽  
Vol 176 (11) ◽  
pp. 1253-1259 ◽  
Author(s):  
Robert C. Marshall ◽  
Martin Doperak ◽  
Michelle Milner ◽  
Charles Motsinger ◽  
Terry Newton ◽  
...  

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