Organization of healthcare in multiple sclerosis

The organization of healthcare for patients with multiple sclerosis (MS) has changed considerably over the past 15 years, with the creation of health networks providing a new impetus towards better coordination of healthcare through a multidisciplinary approach, and improvement of educational training for both patients and healthcare professionals. In this context, therapeutic educational programs (TEPs) for patients have placed patients at the center of their own care pathway, thereby changing the doctor-patient relationship. Today, TEPs cover the various needs of patients in their everyday lives, whether they are medical, social or psychological. However, the arrival of a wide range of new medications, the complexity of therapeutic decisions and management of risk increase the need for organized expertise via centers of resources and competencies (CRCs) for MS, approved since 2016 as part of the French National Neurodegenerative Diseases Plan (NDDP). This NDDP 2014-2019 provides an incentive to change the organization of healthcare for MS patients by adapting it according to regional specificities and resources. Whatever the chosen system of organization, it should allow for a good well-coordinated multidisciplinary care pathway that is easily accessed by patients.