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Mult Scler. 2018 Nov 1:1352458518809326. doi: 10.1177/1352458518809326. [Epub ahead of print]

International consensus on quality standards for brain health-focused care in multiple sclerosis.

Author information

1
Plymouth University Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
2
NHS RightCare, NHS England, London, UK.
3
Shift.ms, Leeds, UK.
4
PharmaGenesis London, London, UK.
5
Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
6
Department of Neurology, Neurosurgery and Medical Genetics, Pirogov Russian National Research Medical University, Moscow, Russia/Demyelinating Diseases Center, Yusupov Hospital, Moscow, Russia.
7
Department of Neurology, Karadeniz Technical University, Trabzon, Turkey.
8
MS and Neuroimmunology Unit, Alfred Health and Eastern Health, Monash University, Melbourne, VIC, Australia.
9
Department of Neurology, Oslo University Hospital, Oslo, Norway.
10
Department for Immune-Mediated Disorders of the Central Nervous System, Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
11
National Institute of Neurology and Neurosurgery, ABC Medical Center, Mexico City, Mexico.
12
Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
13
CRCSEP Neurologie Pasteur 2, Université Côte d'Azur, Nice, France.
14
Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
15
Glasgow MS Clinical Research Centre, Queen Elizabeth University Hospital, Glasgow, UK.
16
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
17
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
18
MS Clinic, Department of Neurology, Centro Hospitalar São João, Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.
19
Clinic of Neurology, Central Military Emergency University Hospital, Bucharest, Romania.
20
Instituto Mexicano de Neurociencias, Hospital Angeles Lomas, Mexico City, Mexico.
21
Department of Neurology, Haukeland University Hospital, Bergen, Norway.
22
Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
23
Department of Neurology, University of Colorado, Denver, CO, USA.
24
Department of Neurology, Ain Shams University, Cairo, Egypt.
25
Department of Neurology, MS Center Dresden, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.
26
Queen Mary University of London, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK.

Abstract

BACKGROUND::

Time matters in multiple sclerosis (MS). Irreversible neural damage and cell loss occur from disease onset. The MS community has endorsed a management strategy of prompt diagnosis, timely intervention and regular proactive monitoring of treatment effectiveness and disease activity to improve outcomes in people with MS.

OBJECTIVES::

We sought to develop internationally applicable quality standards for timely, brain health-focused MS care.

METHODS::

A panel of MS specialist neurologists participated in an iterative, online, modified Delphi process to define 'core', 'achievable' and 'aspirational' time frames reflecting minimum, good and high care standards, respectively. A multidisciplinary Reviewing Group (MS nurses, people with MS, allied healthcare professionals) provided insights ensuring recommendations reflected perspectives from multiple stakeholders.

RESULTS::

Twenty-one MS neurologists from 19 countries reached consensus on most core (25/27), achievable (25/27) and aspirational (22/27) time frames at the end of five rounds. Agreed standards cover six aspects of the care pathway: symptom onset, referral and diagnosis, treatment decisions, lifestyle, disease monitoring and managing new symptoms.

CONCLUSION::

These quality standards for core, achievable and aspirational care provide MS teams with a three-level framework for service evaluation, benchmarking and improvement. They have the potential to produce a profound change in the care of people with MS.

KEYWORDS:

Delphi technique; Multiple sclerosis; benchmarking; consensus; quality improvement; standards

PMID:
30381987
DOI:
10.1177/1352458518809326

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