International journal of MS care最新文献

{"title":"Multiple Sclerosis in the Middle East and North Africa: Perspectives and Challenges.","authors":"Jad Costa, Joelle Massouh, Saloua Mrabet, Bassem Yamout, Gabrielle Macaron","doi":"10.7224/1537-2073.2024-086","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-086","url":null,"abstract":"<p><p>The prevalence of multiple sclerosis (MS) is increasing in the Middle East and North Africa (MENA), in part due to better access to earlier diagnosis. Many MENA countries are now considered to fall in moderate to high MS risk zones. MS in MENA populations occurs at a younger age and is more severe, specifically in North African populations. Large disparities in MS care have been observed among MENA countries. Access to care remains a significant obstacle in countries with low incomes, active wars, and a large number of refugees. The MENA MS population could serve as participants in the evaluation of several genetic, epigenetic, and environmental risk factors for MS. Indeed, low vitamin D levels due to reduced sun exposure in hijab-wearing women might explain the striking rising prevalence in Iran after the Islamic revolution, and the prevention of MS with vitamin D could be evaluated in this community. Moreover, because immigration is part of the history of MENA populations, it can serve as an archetype for the study of the impact of immigration on MS risk and severity. Unfortunately, MENA populations are underrepresented in clinical trials, limiting our understanding of this group. However, with the creation of the Middle East and North Africa Committee for Treatment and Research in Multiple Sclerosis and the emergence of highly specialized MS centers in several countries, better access to care and collaborative research efforts are expanding.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Suppl 1","pages":"T21-T26"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Dance Program for Multiple Sclerosis: Feasibility, Quality of Life, and Motor Imagery Outcomes.","authors":"Alexandra Pfister, Neel Desai, Camryn Lane, Meggi Sweeney Smith, Nora Sekella, Vanessa Zimmerman, Dina Jacobs","doi":"10.7224/1537-2073.2024-040","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-040","url":null,"abstract":"<p><p>Abstract.</p><p><strong>Background: </strong>Dance is a multifaceted physical, cognitive, and social activity and a potentially powerful rehabilitation tool for people with multiple sclerosis (MS). Given the physical factors that may limit individuals with MS and the constraints of the COVID-19 era, virtual dance classes overcome logistical barriers and increase accessibility. The aim of this study was to explore the feasibility and effectiveness of a virtual dance program. Primary outcomes included feasibility measures; secondary outcomes included quality-of-life (QOL) effects and motor imagery capabilities.</p><p><strong>Methods: </strong>The sample included 13 adults with MS. Live, virtual classes were held twice weekly for 5 weeks. Data were collected on feasibility measures. Secondary objectives investigated changes in depression, anxiety, pain, fatigue, brain fog, and QOL before and after the class series. Additionally, motor imagery capabilities were evaluated before and after the intervention.</p><p><strong>Results: </strong>More than 90% of participants completed the series, enjoyed it, felt the virtual platform worked well, and would recommend it to others. This feasibility study did not include a control group, limiting the interpretation of outcomes. Although not statistically significant, the data suggest possible improvement in depression and pain. Finally, motor imagery was less accurate for limbs affected by MS symptoms, a phenomenon known as anisochrony.</p><p><strong>Conclusions: </strong>This study demonstrated that a virtual dance class for participants with MS is feasible and enjoyable and may improve depression and pain, and ultimately QOL. In addition, understanding motor imagery capabilities in MS may inform future dance class design to promote greater physical progress.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"179-185"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apathy in Early Relapsing-Remitting Multiple Sclerosis: Prevalence and Predictors.","authors":"Inês Brás Marques, Gonçalo Diniz de Pinho, Dina Silva, Catarina Chester","doi":"10.7224/1537-2073.2024-059","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-059","url":null,"abstract":"<p><p>Abstract.</p><p><strong>Background: </strong>Apathy, a neuropsychiatric symptom characterized by a lack of motivation and affecting cognitive, emotional, and behavioral domains, is being increasingly recognized in multiple sclerosis (MS), with an estimated prevalence of 19% to 43%. However, apathy remains underinvestigated in early MS. In this study, we aim to evaluate apathy in people with relapsing-remitting MS (RRMS) whose disease duration has been less than 5 years.</p><p><strong>Methods: </strong>The study included 38 people with RRMS with a disease duration of less than 5 years and 38 matched controls. Clinical and comprehensive neuropsychological evaluations were performed. Apathy was evaluated using the Apathy Evaluation Scale, Clinician Version (AES-C).Depressive symptoms, anxiety, fatigue, and quality of life were also assessed.</p><p><strong>Results: </strong>Apathy prevalence was 42.1%. Apathy scores correlated with depressive symptoms, anxiety, fatigue, lower quality of life, younger age, and worse performance in frontal lobe tests (Trail Making Test-A [TMT-A] and Symbol Digit Modalities Test). Independent apathy predictors were depressive symptoms (OR, 4.05; 95% CI, 1.22-13.5; <i>P</i> = .023), global quality of life (OR, 1.7; 95% CI, 1.08-2.64; <i>P</i> = .021), and TMT-A score (OR, 1.14; 95% CI, 1.02-1.27; <i>P</i> = .020).</p><p><strong>Conclusions: </strong>Apathy is a disabling symptom that is present in a significant percentage of people in the first years after they have been diagnosed with RRMS. Thus, people with MS should should be routinely screened for apathy, and symptoms should be managed when it occurs. We identified depressive symptoms, low quality of life, and executive dysfunction as predictors of apathy in this population.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"173-178"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Therapeutic Patient Education Program on the Quality of Life of People With Multiple Sclerosis: A Quasi-Experimental Study.","authors":"Ilham Raji, Hind Bourkhime, Fedwa Nejjar, Mohammed Faouzi Belahsen","doi":"10.7224/1537-2073.2024-094","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-094","url":null,"abstract":"<p><strong>Background: </strong>Managing multiple sclerosis (MS) is complex, highlighting the need for structured therapeutic patient education (TPE) to improve quality of life (QOL) and help patients better manage daily challenges. This study aimed to evaluate the effect of a structured TPE program on QOL and, secondarily, to assess its effects on anxiety, depression, and MS-related knowledge among people with MS.</p><p><strong>Methods: </strong>This quasi-experimental before-and-after study included 164 people with MS who completed a TPE program. QOL was the primary outcome, measured with the MS Quality of Life54 (MSQOL-54). The secondary outcomes of level of anxiety, depression, and MS knowledge were assessed with the Hospital Anxiety and Depression Scale and the MS Knowledge Questionnaire. Data were collected at baseline and 3 months post intervention. The Wilcoxon signed rank test was used for analysis, with effect sizes calculated (<i>r</i>).</p><p><strong>Results: </strong>After the intervention, a significant improvement in the MSQOL-54 mental composite score was observed (<i>P</i><.001) from 51.39 (IQR, 41.26-66.89) to 63.60 (IQR, 53.26-73.77), with a large effect size (<i>r</i>=0.54). No significant change was observed in the physical composite score, although the subscales of social function, health perception, and distress showed significant improvements (<i>P</i><.05). Anxiety and depression scores decreased significantly (<i>P</i><.001) from 9.00 (IQR, 7.00-10.00) to 5.00 (IQR, 2.00-7.00) (<i>r</i>=0.5) and from 7.00 (IQR, 4.00-8.00) to 5.00 (IQR, 3.00-6.00) (<i>r</i>= 0.55), respectively. MS knowledge scores improved significantly (<i>P</i><.001) from 5.00 (IQR, 4.00-7.00) to 12.00 (IQR, 10.00-14.00) (<i>r</i>=0.61); these results suggested high effect sizes.</p><p><strong>Conclusions: </strong>Our results suggest that a TPE program may be effective in improving mental QOL and MS-related knowledge as well as in reducing anxiety and depression in people with MS. Integrating and optimizing tailored TPE programs within continuous care is essential to maximize overall QOL benefits.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 3","pages":"163-172"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Sclerosis Care in a Low/Middle-Income Setting in South West India.","authors":"Lekha Pandit","doi":"10.7224/1537-2073.2024-082","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-082","url":null,"abstract":"<p><p>Multiple sclerosis (MS) awareness has increased in India, especially in the past decade. Growing awareness of the disease among medical specialists and the public and the availability of MRI in many cities in India are partly responsible. However, income inequity and the need for out-of-pocket spending create special challenges for MS care within the region. In low-income settings, some of these limitations may be partially mitigated through subsidized inpatient and outpatient care, prescription of generic and biosimilar alternatives of MS disease-modifying therapies, and remote monitoring of patients with stability. Improving the knowledge gap among medical professionals and generating country- specific guidelines are equally important. This paper will highlight some successful measures, using the example of the Mangalore Demyelinating Disease Registry.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Suppl 1","pages":"T17-T20"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearing-Off Effect Reports in People With Multiple Sclerosis Receiving Ocrelizumab.","authors":"Sarah A Morrow, Victor Gitman, Spasojevic Sofija, Jessica Rassi, Noemi Pasquarelli, Kocho Fitovski, Galina Vorobeychik","doi":"10.7224/1537-2073.2024-083","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-083","url":null,"abstract":"<p><strong>Background: </strong>A wearing-off effect has been reported in people with multiple sclerosis (MS) receiving ocrelizumab and other monoclonal antibodies. We sought to describe the real-world occurrence of wearing-off effect among people with MS in Canada treated with ocrelizumab.</p><p><strong>Methods: </strong>Canadian self-reports coded to the Medical Dictionary for Regulatory Activities preferred term <i>therapeutic response shortened</i> (which included reports using the terms <i>wearing-off</i>, <i>crap gap</i>, <i>wore off</i>, or <i>end-of-cycle phenomenon; TRS</i>) between November 5, 2008, and March 15, 2023, were identified from the Roche Global Safety Database. Cases were then linked to patient-level data from the Canadian Roche Patient Support Program (COMPASS). Only people with MS who had received 3 or more doses of ocrelizumab were included.</p><p><strong>Results: </strong>A total of 10,055 people with MS in Canada received 3 or more doses of ocrelizumab within COMPASS. <i>TRS</i> was reported 140 times among 138 unique cases (1.3%) over an average of 7.4 infusions. Discontinuation of ocrelizumab was generally uncommon. In the overall COMPASS population, 11.4% (1143 of 10,055) discontinued ocrelizumab. Among those who reported <i>TRS</i>, 15.9% (22 of 138) discontinued while the majority (116 of 138; 84.1%) continued ocrelizumab treatment. Of individuals reporting the adverse event of interest, those with relapsing-remitting MS more frequently remained on therapy (98 of 112; 87.5%) compared with those with primary progressive MS (18 of 26; 69.2%).</p><p><strong>Conclusions: </strong>A wearing-off effect was infrequently reported and did not limit treatment among people with MS in the real-world COMPASS patient support program.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 2","pages":"154-162"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Usual-Care Physiotherapy on Physical Activity and Self-Efficacy in People With Multiple Sclerosis: An Observational Longitudinal Study.","authors":"Alessandro Torchio, Giulia Fusari, Davide Cattaneo, Cristina Grosso, Chiara Pagliari, Valeria Crispiatico, Gloria Perini, Johanna Jonsdottir","doi":"10.7224/1537-2073.2024-043","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-043","url":null,"abstract":"<p><strong>Background: </strong>People with multiple sclerosis (MS) experience motor and nonmotor symptoms that affect daily life. Although regular physical activity (PA) may enhance the overall well-being of people with MS, they tend to have lower activity levels than healthy individuals. This study aims to investigate the impact of usual-care physiotherapy on PA and self-efficacy in people with MS and identify prerehabilitation factors that influence positive changes in PA with physiotherapy.</p><p><strong>Methods: </strong>Forty-one people with MS undergoing physiotherapy with a median (IQR) age of 54.00 (17.00) years and an Expanded Disability Status Scale score of 6.00 (2.00) points were assessed on the first days (T0) and last days of their rehabilitation period (T1), and 6 weeks after it ended (T2). Instrumental assessment utilized Fitbit Versa trackers, measuring daily steps and moderate/vigorous PA engagement (MVPA). Self-efficacy, perceived fatigue, walking ability, and quality of life were measured using the Self-Efficacy in Multiple Sclerosis scale (SEMS), the Fatigue Severity Scale, the 10-Meter Walk Test, and the Short Form-12 Health Survey.</p><p><strong>Results: </strong>Usual-care physiotherapy did not improve (P > .05) daily steps (T0: 4139 [3333]; T1: 4438 [2505] steps per day), MVPA (T0: 6.00 [15.6]; T1: 10.52 [16.30] minutes per day), or self-efficacy (SEMS: T0: 42.0 [10.8]; T1: 40.5 [8.7] points). Low perceived fatigue, better overall PA, and good physical health perception were identified as predictors of positive changes in PA after physiotherapy.</p><p><strong>Conclusions: </strong>Usual-care physiotherapy focusing on mobility did not result in significant improvements in PA or self-efficacy for people with MS. Perceived fatigue and overall PA before physiotherapy impacted PA levels after rehabilitation. Future interventions may benefit from integrating motivational strategies into the rehabilitation protocol to increase PA levels.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q2","pages":"144-153"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"You've Got a Friend in Me: The Importance of a Confidant and Its Role on Health and Well-Being Among Women With Multiple Sclerosis.","authors":"Lauren B Strober, Kristen Ngai, Erica Weber","doi":"10.7224/1537-2073.2024-054","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-054","url":null,"abstract":"<p><strong>Background: </strong>Social support plays a significant role in maintaining one's health and well-being. A perceived or objective lack of close friendships can indicate loneliness and/or limited social support. The present study aimed to examine the impact of having a close friend on the overall health and psychological well-being (PWB) of women with multiple sclerosis (MS).</p><p><strong>Methods: </strong>A prospective national study examining factors associated with unemployment in MS enrolled 160 women. As part of an online survey, participants were asked whether they had someone they could confide in. Group comparisons on measures of health, PWB, quality of life (QOL), social support, and marital/partner satisfaction were made between those who said <i>yes</i> and those who said <i>no</i>. Regression analyses were also conducted to determine the role of having a confidant and other lifestyle factors related to health, PWB, and QOL.</p><p><strong>Results: </strong>Approximately 19% of participants reported not having a confidant. These individuals reported worse perceived general, physical, and mental health and more severe depression, anxiety, fatigue, sleep disturbance, and pain. They also reported lower levels of PWB, life satisfaction, social support, and marital/partner satisfaction. Regression analyses revealed that having a confidant was a significant predictor of physical and mental health, PWB, and QOL, even when considering other lifestyle factors.</p><p><strong>Conclusions: </strong>Results suggest that the simple question <i>Do you have someone to confide in</i>? may be an important indicator of individuals' health and well-being. Practitioners should routinely assess patients' socialization and discuss the importance of social networks and communal activity.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q2","pages":"134-143"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Diverse Caregiver Experiences and Their Impact on Caregiver Burden in Multiple Sclerosis.","authors":"Annette Okai, Brian Elter, Mark Williams","doi":"10.7224/1537-2073.2024-025","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-025","url":null,"abstract":"<p><p><b>BACKGROUND:</b> For 80% of people living with multiple sclerosis (MS), informal care is provided by a caregiver. Caregivers spend an average of 6.5 hours a day providing care, which equates to nearly full-time, unpaid work. Although it is widely accepted that informal caregivers play an essential support role in the lives of people with MS, there is a general paucity of MS caregiver research. The findings of the few available research studies are often interpreted from a clinical perspective, without consideration of the many sociocultural aspects that produce a widely heterogeneous population of caregivers and care recipients. For many caregivers, caregiving can be accompanied by considerable burden, which can have a negative impact on their mental and physical health. However, with the lack of diverse caregiver research available, the full extent of the caregiver experience, burdens, and unmet needs is still relatively unknown. In this review, we discuss the key contributing factors to caregiver burden in MS across diverse caregiving groups, identify gaps in our understanding of caregiving responsibilities as they contribute to caregiver burden, and discuss potential strategies and interventions to reduce caregiver burden. We examine these topics from the clinician, caregiver, and care recipient perspectives.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q2","pages":"125-133"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Clinical Pharmacy Services Into Comprehensive Multiple Sclerosis Care Teams: A Narrative Review of 4 Models.","authors":"Nina Bozinov, Autumn Ramsrud, Jenelle H Montgomery, Steven Merrill, Sarah N Rajkovic, Kavita V Nair","doi":"10.7224/1537-2073.2024-019","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-019","url":null,"abstract":"<p><p><b>BACKGROUND:</b> Over the past 30 years, the treatment landscape for multiple sclerosis (MS) has become increasingly complex. All MS disease-modifying therapies (DMTs) and several symptomatic medications are designated specialty medications, and their financial coverage is subject to complicated insurance processes and a wide array of patient support programs. Many patients receiving MS DMTs need ongoing monitoring or enrollment in a Risk Evaluation and Mitigation Strategy program. Integrated pharmacy services can facilitate financial, technical, and educational aspects of providing specialty medications. Although pharmacy services are often part of the care team for patients with complex chronic medical conditions, MS clinics may not have the benefit of full pharmacy services. We present 4 models of MS health care delivery and discuss how integrating pharmacy services into an MS multidisciplinary team can potentially increase the efficiency and quality of health care delivery. Clinical pharmacists, working with other providers, can optimize and accelerate access to medications requiring prior authorization, improve patient outcomes by promoting medication adherence and persistence, enhance safety by monitoring laboratory findings and potential drug-drug interactions, and minimize clinical workflow burden by improving process efficiency, which may be cost-effective for the MS health care delivery system.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q2","pages":"117-124"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}