Diseño de una vía clínica para la atención a los pacientes con esclerosis múltiple

Oreja‐Guevara, Celia; Miralles, Ambrosio; Garcı́a-Caballero, Juan; Noval, Susana; Gabaldón, Laura; Esteban-Vasallo, María D.; García-Matres, M.J.; Bayón, Carmen; Royo, Arantxa; González, Antonio; Hernánz, Ángel; López-Pajares, M.R.; Morante, Juana; Díez‐Tejedor, Exuperio

doi:10.1016/s0213-4853(10)70003-7

Cited by 7 publications

(10 citation statements)

References 23 publications

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“…The physical and psychological consequences are a heavy burden to bear, especially given the recurrence of relapses. Accordingly, the array of necessary care-related activities throughout the MS care process is broad, varying from simple to complex procedures, and necessitates a high degree of coordination in order to guarantee continuity of care [2728]. In sum, the MS care process is the whole of care-related activities that try to answer a specific patients’ needs over time.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Advancing a Systemic Perspective on Multidisciplinary Teams: A Comparative Case Study of Work Organisation in Four Multiple Sclerosis Hospitals

Pless¹,

Hootegem²,

Dessers³

2018

International Journal of Integrated Care

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Introduction:Many care organisations claim to employ multidisciplinary teams, but the term is used to describe quite different forms of collaboration. A systemic view of the work organisation of care delivery is presented and applied in this article that allows to identify and understand often overlooked yet important differences regarding team composition, working relationships and therapeutic relationships.Theory and Methods:We used modern socio-technical systems theory to study care delivery for a particular patient population as a system of interrelated activities. The concept of work organisation refers to the way in which the composite task of care delivery is divided into distinct tasks and how these are grouped in either monodisciplinary or multidisciplinary organisational units. The systemic perspective was applied in a comparative case study of four Multiple Sclerosis hospitals.Results:Among the hospitals, one was characterised by a functional work organisation, with similar tasks grouped in monodisciplinary teams. Cross-disciplinary working and therapeutic relationships were established on an ad hoc basis. The three other hospitals adopted a more process-oriented work organisation (which groups all tasks related to a specific care process within a single, multidisciplinary team). The more process-oriented the work organisation, the more working relationships and therapeutic relationships appeared to be fixed and continuous.Conclusion and discussion:The systemic view adopted in this study yields a better understanding of multidisciplinary teams through the concept of work organisation. The actual composition of multidisciplinary teams, and the related working and therapeutic relationships will vary depending on the type of underlying work organisation. Further validation of this conclusion will be needed in other settings.

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Section: Theoretical Frameworkmentioning

confidence: 99%

Advancing a Systemic Perspective on Multidisciplinary Teams: A Comparative Case Study of Work Organisation in Four Multiple Sclerosis Hospitals

Pless¹,

Hootegem²,

Dessers³

2018

International Journal of Integrated Care

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“…This means developing new approaches that incorporate a wide range of pharmacological and non-pharmacological strategies that focus on the needs of people living with the disease as individuals, and aim to reduce disease activity, slow disability progression and improve management of symptoms such as depression, immobility, fatigue, and others, which can be caused by MS [10–12]. …”

Section: Resultsmentioning

confidence: 99%

“…The best treatment regimen is often specific to the patient and best achieved through continuity of care with a team of physicians and allied professionals [11, 12]. Healthcare decision-makers must realize that this outcome is often compromised in modern hospitals, where, in the name of efficiency, patients will generally see a sequence of different doctors and may receive increasingly fragmented care.…”

Section: Resultsmentioning

confidence: 99%

“…All available therapies and their respective risks and benefits should be communicated to patients by their physicians, and patients should also have access to other reliable, independent sources to ensure that they are empowered to make informed decisions [11, 14–16]. In addition, affording patients psychological and social support as part of their treatment package is likely to ensure the greatest possible mitigation of the potential financial, social, and psychosocial burdens associated with MS [8, 12, 17–22]. …”

Section: Resultsmentioning

confidence: 99%

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Future MS care: a consensus statement of the MS in the 21st Century Steering Group

et al. 2012

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The “MS in the 21st Century” initiative was established with the purpose of (1) defining how multiple sclerosis (MS) treatment and standards of care should look in the 21st century; (2) developing a minimum standard of care across the world; and (3) motivating the broad MS community to align standards of care and challenge the current treatment paradigm. The aim was to develop a consensus statement to reach and influence the broader MS community. An expert steering group from Europe and Canada—consisting of neurologists, patient advocates, a pharmacoepidemiologist/pharmacoeconomist, and representatives from national MS centers—participated in a series of workshop-driven meetings between February 2011 and 2012. After three phases of discussions, the steering group identified that the overall vision for future care of MS should be full access to personalized treatment, with reimbursement, to achieve freedom from disease. They constructed seven overall principles that support this vision: personalized care, patient engagement, commitment to research, regulatory body education and reimbursement issues, new endpoints in clinical trials, more therapy options, and MS centers of excellence. This consensus statement outlines the key aspects of the seven principles that need to be addressed. The “MS in the 21st Century Steering Group” hopes that this consensus statement acts as a call to action for healthcare providers and decision-makers to address simultaneously the overarching principles that will guide patient management in order to improve outcomes for people with MS.

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“…The healthcare needs of patients with MS depend on the symptoms, the degree of disability, and the existence of co-morbidities [1,10]. Since it is a chronic disorder, care must include patients as well as their relatives and caregivers [21].…”

Section: Introductionmentioning

confidence: 99%

Social value of a set of proposals for the ideal approach of multiple sclerosis within the Spanish National Health System: a social return on investment study

Torres

Fernández²,

Carrascal

et al. 2020

BMC Health Serv Res

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Background: Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disease that in many cases produces disability, having a high impact in patients' lives, reducing significantly their quality of life. The aim of this study was to agree on a set of proposals to improve the current management of MS within the Spanish National Health System (SNHS) and apply the Social Return on Investment (SROI) method to measure the potential social impact these proposals would create. Methods: A Multidisciplinary Working Team of nine experts, with representation from the main stakeholders regarding MS, was set up to agree on a set of proposals to improve the management of MS. A forecast SROI analysis was carried out, with a one-year timeframe. Data sources included an expert consultation, a narrative literature review and a survey to 532 MS patients. We estimated the required investment of a hypothetical implementation, as well as the potential social value that it could create. We calculated outcomes in monetary units and we measured intangible outcomes through financial proxies. Results: The proposed ideal approach revealed that there are still unmet needs related to MS that can be addressed within the SNHS. Investment would amount to 148 million € and social return to 272 million €, so each euro invested could yield almost €2 of social return. Conclusions: This study could guide health interventions, resulting in money savings for the SNHS and increases in patients' quality of life.

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Diseño de una vía clínica para la atención a los pacientes con esclerosis múltiple

Cited by 7 publications

References 23 publications

Advancing a Systemic Perspective on Multidisciplinary Teams: A Comparative Case Study of Work Organisation in Four Multiple Sclerosis Hospitals

Advancing a Systemic Perspective on Multidisciplinary Teams: A Comparative Case Study of Work Organisation in Four Multiple Sclerosis Hospitals

Future MS care: a consensus statement of the MS in the 21st Century Steering Group

Social value of a set of proposals for the ideal approach of multiple sclerosis within the Spanish National Health System: a social return on investment study

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