An Audit of a New System of Self–Referral in the Management of Multiple Sclerosis

2002 ◽  
Vol 4 (1) ◽  
pp. 10-16
Author(s):  
Áine Carroll ◽  
Paul Mattison ◽  
Catherine Comiskey
Keyword(s):  
Multiple Sclerosis ◽  
Lead Time ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
The Self ◽  
Referral System ◽  
Disability Status ◽  
The Mean ◽  
Multiple Sclerosis Patients ◽  
New System

A random sample of the referral notes of 35 multiple sclerosis patients experiencing relapse and referred via the current general practitioner (GP) system was reviewed. The time between receipt of the referral and assessment/admission (lead time) was examined. The mean value was obtained and a self referral system was initiated and monitored for a period of five months. The mean referral times were compared. The patients' disability status before and after treatment was measured using the Expanded Disability Status Scale (EDSS) and Functional Independence Measure (FIM), and we invited the patients' opinions about the self-referral system. The goals of the newly implemented self-referral system were to reduce lead time to less than 6.5 days, improve patient disability, and avoid inappropriate referral; the new system was also to be “user friendly.” The new system reduced referral times by a statistically significant amount (P = 0.0016). There was a significant objective improvement in patients' disability as measured by the EDSS and FIM scores (P = 0.031 and P = 0.04, respectively). There was a subjective improvement, and patients expressed a preference for the new system. There were no inappropriate referrals. These findings suggest that the self-referral system is efficient and effective and should be further evaluated. (Int J MS Care. 2002; 4: 10–12)

Effect of Self - Care Program on the Self- Esteem of Multiple Sclerosis Patients

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
H. Madani ◽  
H. Navipoor ◽  
P. Roozbayani
Keyword(s):  
Multiple Sclerosis ◽  
Self Care ◽  
Care Program ◽  
Self Esteem ◽  
The Self ◽  
Self Report ◽  
The Mean ◽  
Muscular Spasm ◽  
Multiple Sclerosis Patients ◽  
Paired T Test

Aims:According to decreased self- esteem in multiple sclerosis (MS) patients, it is necessary to utilize appropriate methods in order to improve self- esteem in MS patients. So this study was conducted on patients with MS supported by the Iranian MS society for determining the effect of self - care program on their self- esteem.Method:In this semi - experimental study 34 patients with MS who were not in the acute phase of disease were selected. The data were collected via personal questionnaires, problem list, Cooper and smith standard questionnaire for self- esteem and self report check lists. Self - care program(self - care for muscular spasm, fatigue, constipation and amnesia and …) was educated, then it was performed for one month period and the data were analyzed using paired t- test, wilcoxon, croscal - wallis and manwithney tests.Results:Application of self - care program improve the self- esteem and reduced some symptoms such as muscular spasm, fatigue, constipation and amnesia in MS patients. The mean valve of self- esteem increased from 54 before performing the program to 68 after the program ( p < 0.05).Conclusion:Using self-care program can be an effective method for improving self- esteem of MS patients.

scholarly journals Reducing return of disease activity in patients with relapsing multiple sclerosis transitioned from natalizumab to teriflunomide: 12-month interim results of teriflunomide therapy

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731882461
Author(s):  
Stanley L Cohan ◽  
Keith Edwards ◽  
Lindsay Lucas ◽  
Tiffany Gervasi-Follmar ◽  
Judy O’Connor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Brain Magnetic Resonance Imaging ◽  
T2 Lesions ◽  
Disability Status ◽  
The Mean ◽  
Multiple Sclerosis Patients ◽  
Mean Time ◽  
Relapsing Multiple Sclerosis

Background Natalizumab is an effective treatment for relapsing multiple sclerosis. Return of disease activity upon natalizumab discontinuance creates the need for follow-up therapeutic strategies. Objective To assess the efficacy of teriflunomide following natalizumab discontinuance in relapsing multiple sclerosis patients. Methods Clinically stable relapsing multiple sclerosis patients completing 12 or more consecutive months of natalizumab, testing positive for anti-John Cunningham virus antibody, started teriflunomide 14 mg/day, 28 ± 7 days after their final natalizumab infusion. Physical examination, Expanded Disability Status Scale, laboratory assessments, and brain magnetic resonance imaging were performed at screening and multiple follow-up visits. Results Fifty-five patients were enrolled in the study. The proportion of patients relapse-free was 0.94, restricted mean time to first gadolinium-enhancing lesion was 10.9 months and time to 3-month sustained disability worsening was 11.8 months. The mean number of new or enlarging T2 lesions per patient at 12 months was 0.42. Exploratory analyses revealed an annualized relapse rate of 0.08, and a proportion of patients with no evidence of disease activity of 0.68. Forty-seven patients (85.5%) reported adverse events, 95% of which were mild to moderate. Conclusions Teriflunomide therapy initiated without natalizumab washout resulted in a low rate of return of disease activity. Clinicians may consider this a worthwhile strategy when transitioning clinically stable patients off natalizumab to another therapy. ClinicalTrials.gov Identifier: NCT01970410

scholarly journals Epidemiological and functional profile of patients diagnosed with multiple sclerosis in Manaus, Amazonas

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
Luciana Moreira de Sousa ◽  
Edinangela Silva de Oliveira ◽  
Nisi Alessandra de Carvalho Sousa ◽  
Guilherme Peixoto Tinoco Arêas ◽  
Fernando Zanela da Silva Arêas
Keyword(s):  
Multiple Sclerosis ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Functional Profile ◽  
Immune Mediated ◽  
Diagnostic Time ◽  
Subsequent Application ◽  
Reference Hospital ◽  
The Mean ◽  
Epidemiological Characteristics

Multiple sclerosis (MS) is an immune-mediated, inflammatory disease characterized by repeated episodes of demyelization. Objective: The present study aimed to trace the epidemiological and functional profile of patients with Multiple Sclerosis treated at a Reference Hospital in Manaus-AM. Method: 80 charts were selected for screening and subsequent application of the Functional Independence Measure (MIF) scale. Results: 32 patients were included in the study, 23 females (74%), whose mean age was 35 (± 12) years, with a relationship between females and males of 2.5. The mean diagnostic time for men was 7.8 years and for women of 5.3 years. The mean score on the Total MIF scale was 110.9 (± 17.5). Conclusion: Epidemiological characteristics are in line with most similar studies, but lack further studies aimed at assessing the functionality of individuals with MS.

Self-rated physical health predicts change in disability in multiple sclerosis

2008 ◽  
Vol 14 (7) ◽  
pp. 999-1002 ◽  
Author(s):  
J Drulovic ◽  
T Riise ◽  
M Nortvedt ◽  
T Pekmezovic ◽  
M Manigoda
Keyword(s):  
Multiple Sclerosis ◽  
Physical Health ◽  
Objective Measure ◽  
The Self ◽  
Disease Modifying Therapies ◽  
Sf 36 ◽  
Physical Scale ◽  
Disability Status ◽  
The Mean

Objective To examine whether self-rated physical health, as measured by the Physical Functioning Scale (PF) and the Role-physical Scale (RF) of the SF-36 Health Survey, could predict change in disability measured by the Expanded Disability Status Scale (EDSS) in patients with multiple sclerosis (MS) over a follow-up period of 3 years. Methods A group of 156 clinically definite MS patients (Poser criteria), who had never been treated with disease-modifying therapies, were recruited consecutively from an outpatient clinic setting at the Institute of Neurology, Belgrade. The self-rated physical health was measured by using PF and RF of the SF-36. Results At follow-up, 33 out of 156 patients (21%) had dropped out. The mean EDSS score had increased from 3.7 to 4.5. Multiple regression analyses using change in EDSS as the dependent variable and baseline scores of EDSS and RF as independent variables showed a significant effect for RF (standardized beta = –0.21). A similar but non-significant effect was found for PF. Dichotomizing change in disability according to clinically meaningful deterioration and using logistic regression, an odds ratio of 1.27 (95% confidence interval 1.01–1.62) was found for the smallest unit of change in the self-rated scale. This means that patients who rated their own physical health as poor had a higher increase in disability compared with patients with the same level of disability at baseline who rated their physical health better. Conclusions MS patients’ perception of their health comprises information predictive for disease development not included in the more objective measure of disability status.

Well-being and disease severity of multiple sclerosis patients following a physical activity program

2021 ◽  
Vol 34 ◽  
Author(s):  
Luísa Pedro ◽  
José Pais-Ribeiro ◽  
João Páscoa Pinheiro
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Multiple Sclerosis ◽  
Disease Severity ◽  
Self Regulation ◽  
Well Being ◽  
The Self ◽  
The Mean ◽  
Multiple Sclerosis Patients ◽  
Perception Of Disease

Abstract Introduction: Multiple sclerosis (MS) is a chronic disease of the central nervous system that mainly affects young adults, promoting a great impact on functionality. Fatigue is a very common symptom, associated with multiple impairments in sensitivity, muscle activity, neuromotor control, balance, cognition and problem-solving ability. MS leads to strong functional restrictions, particularly in the context of daily living activities, as well as in patient participation. Objective: To understand the implications of a self-regulation program in the perception of well-being and mental health in MS patients. Methods: A set of exercises was implemented for use in daily activities, supported by different studies with MS patients. Patients were asked to classify the severity of their disease and to use the Mental Health Inventory (MHI-38), at the beginning (time A) and at the end (time B) of the self-regulation program. We used the Statistical Package for the Social Sciences (SPSS) version 25. A non-parametric statistical hypothesis test (Wilcoxon test) was used to analyze the variables. Results: The mean age was 44 years old, with patients between the ages of 20 and 58. 58.3% were women, 37.5% were currently married, 67% were retired and the mean level of education was 12.5 years. The correlation between the perception of disease severity and psychological well-being before the self-regulation program (r = 0.26, p < 0.05) and after the intervention (r = 0.37, p < 0.01) suggests a low to moderate correlation. Conclusion: The implementation of the self-regulatory model, through the promotion of physical activity in patients with MS, had a positive impact of clinical rehabilitation, well-being, and perception of disease severity of these people.

Disability status and dental pathology in multiple sclerosis patients

2015 ◽  
Vol 4 (6) ◽  
pp. 567-571 ◽  
Author(s):  
Adriana Octaviana Dulamea ◽  
Voicu Boscaiu ◽  
Maria Mirela Sava
Keyword(s):  
Multiple Sclerosis ◽  
Dental Pathology ◽  
Disability Status ◽  
Multiple Sclerosis Patients
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