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

Little 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. We 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. Of 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. Canadian 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.

Informations de copyright

Copyright © 2022 Marrie, Donkers, Jichici, Hrebicek, Metz, Morrow, Oh, Pétrin, Smyth and Devonshire.

Déclaration de conflit d'intérêts

RM receives research funding from: CIHR, Research Manitoba, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Foundation, Crohn's and Colitis Canada, National Multiple Sclerosis Society, CMSC. She is a co-investigator on a study funded in part by Biogen Idec and Roche Canada. She is supported by the Waugh Family Chair in Multiple Sclerosis. SD receives research funding from the: Canadian Institute of Health Research, Multiple Sclerosis Society of Canada, Saskatchewan Health Research Foundation, Saskatchewan Centre for Patient Oriented Research, Saskatchewan Ministry of Health, Branch Out Neurological Foundation, Praxis Spinal Cord Institute, and Canadian Partnership for Stroke Recovery. LM receives research funding from the MS Society of Canada, Brain Canada, Roche, Biogen Idec and the Government of Alberta. SM has in the past 3 years served on advisory boards for Biogen Idec, Bristol Myers Squibb/Celgene, EMD Serono, Novartis, Roche, Sanofi Genzyme, Teva Neurosciences; Received Investigator Initiated Grant Funds from MS Society of Canada, National MS Society and CIHR, as well as Biogen Idec, Novartis, Roche, Sanofi Genzyme; Acted as site PI for multi-center trials funded by AbbVie, Bristol Myers Squibb/Celgene, Novartis, Genzyme, Roche, Sanofi Genzyme. JO has received research funding from the MS Society of Canada, National MS Society, NIH, Brain Canada, Biogen-Idec, Roche, and EMD-Serono. She has received personal compensation for consulting or speaking from Biogen-Idec, BMS, EMD-Serono, Novartis, Roche, Sanofi-Genzyme, Roche, and Alexion. She is supported by the Waugh Family Chair in MS Research at the University of Toronto. PS has received unrestricted research support from Biogen-Idec; and has received consulting fees and honoraria for speaking activities from Biogen-Idec and Roche. She receives research funding from the MS Society of Canada, Brain Canada, Roche, Biogen Idec and the Government of Alberta. VD has received honoraria for speaking/advisory boards from Biogen, Serono, Roche, Sanofi-Genzyme, Novartis and Teva Neuroscience. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.