Models of Care in Multiple Sclerosis: A Survey of Canadian Health Providers

Abstract

ObjectiveLittle work has evaluated integrated models of care in multiple sclerosis (MS) and the composition of MS care teams across Canada is largely unknown. We aimed to gather information regarding existing models of MS care across Canada, and to assess the perceptions of health care providers (HCPs) regarding the models of care required to fully meet the needs of the person with MS.MethodsWe conducted an anonymous online survey targeting Canadian HCPs working in MS Clinics, and neurologists delivering MS care whether or not they were based in an MS Clinic. We queried the types of HCPs delivering care within formal MS Clinics, wait times for HCPs, the perceived importance of different types of HCPs for good quality care, assessments conducted, and whether clinic databases were used. We summarized survey responses using descriptive statistics.ResultsOf the 716 HCPs to whom the survey was distributed, 100 (13.9%) people responded. Of the 100 respondents, 85 (85%) indicated that their clinical practice included people with MS and responded to specific questions about clinical care. The most common types of providers within MS Clinics with integrated models of care were neurologists and MS nurses. Of 23 responding MS Clinics, 10 (43.5%) indicated that there were not enough neurologists, and 16 (69.6%) indicated that there were not enough non-neurologist HCPs to provide adequate care. More than 50% of clinics reported wait times exceeding 3 months for physiatrists, physiotherapists, psychiatrists, psychologists, neuropsychologists and urologists; in some clinics wait times for these providers exceeded 1 year. Multiple disciplines were identified as important or very important for delivering good quality MS care. Over 90% of respondents thought it was important for neurologists, nurse practitioners, MS nurses and psychiatrists to be co-located within MS Clinics.ConclusionCanadian HCPs viewed the ideal MS service as being multidisciplinary in nature and ideally integrated. Efforts are needed to improve timely access to specialized MS care in Canada, and to evaluate how outcomes are influenced by access to care.

Good multiple sclerosis (MS) care and how to get there in Canada: Perspectives of Canadian healthcare providers working with persons with MS

“…We recently conducted a survey exploring the perspectives of healthcare providers regarding which models of MS care are best suited to meet the needs of persons with MS in Canada. The quantitative data from the survey have been published elsewhere (10). The present paper used a qualitative descriptive approach (11) to analyze the data from participants who responded to additional open-ended survey questions.…”

“…The survey was open and collected data from mid-September 2021 to January 31, 2022. Further details regarding the recruitment and survey administration can be found elsewhere (10).…”

“…The larger MS Model of Care Survey was distributed across Canada (10). Of 85 total respondents, 57 (67%) health care providers responded to the open-ended questions and were included in this qualitative analysis.…”

Opinion: The role of the registered dietitian nutritionist in multiple sclerosis care in the United States

“…To meet this patient desire, we propose that Registered Dietitian Nutritionists (RDNs) be included on the multidisciplinary care team for people with MS in the United States. In Canada, RDNs are included on the multidisciplinary care team for MS and are considered important members according to a survey of MS health care providers ( 18 ). This article provides an overview of RDNs and details some of the key reasons why their inclusion may be beneficial to the care of people with MS.…”

A continuum of languishing to flourishing: exploring experiences of psychological resilience in multiple sclerosis family caregivers

“…Across all disease subtypes, MS is characterized by increasing impairment over time. Despite disease severity, the life expectancy of persons with MS has increased significantly over the past two decades (Sanai et al, 2016 ), likely attributable to improvements in treatments, understanding of comorbidities, and multidisciplinary integrated medical care models (Marrie, Donkers et al, 2022 ). MS is now considered a life-long disease, subject to the co-occurrence of natural ageing processes (Awad & Sütve, 2010 ; Motl et al, 2021 ).…”