Can we optimize our teams? Multidisciplinary care for multiple sclerosis

Established in 2003, the multiple sclerosis (MS) regional hospital network in the Auvergne area of France links not only neurologists but also many other specialists (e.g., urologists, ophthalmologists) and more than 400 other allied healthcare professionals (including physiotherapists, nurses, occupational therapists) involved in the care of patients with MS. This multidisciplinary network aims to improve quality of care for an estimated 1600 + MS patients in the Auvergne region through numerous training courses and medical support programs. The initiative is supported by the regional regulatory authority and receives public funding from the Auvergne regional state health insurance office. The Auvergne MS network has facilitated improvements in quality of care by coordinating patient care in the proximal vicinity of the patient's home and has provided useful information about MS epidemiology (incidence and prevalence) in the region. Using a multidisciplinary approach, the Auvergne MS network has explored other avenues of domiciliary-based care to seek improvements in the patient-centered management of MS. These include: access to high-dose methylprednisolone in the home, ensuring appropriate supervision and support; participation in national clinical research programs coordinated from hospital centers of excellence; provision of multidisciplinary clinic services where healthcare professionals across different disciplines can attend to the patient on the same day in the same center of care; development of individual and group-based cognitive therapy programs; educational programs focusing on the management of fatigue and cognitive impairment associated with MS; and educational programs focusing on optimal use of immunomodulating agents in MS patients.