为患有多发性硬化症的老年人实施多学科方法：老年神经病学实践。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-24 DOI:10.1016/j.msard.2024.105952

Mara Bahri , Kristi Epstein , Erin Stevens , Ashley E. Rosko , Sarita Maturu , Yinan Zhang

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引用次数: 0

摘要

背景：患有多发性硬化症（MS）的老年人面临着MS病理生理学与年龄相关的变化以及老年综合征重叠所带来的独特挑战。对于迅速增长的老年多发性硬化症患者，需要以老年病学为重点的多学科治疗：为多发性硬化症老年人设计并实施老年多学科诊所：方法：我们介绍了在一家机构内通过实施老年多发性硬化症门诊，发展老年多发性硬化症多学科治疗方法的情况。该门诊模式由神经内科和老年医学合作构想而成，旨在为患有多发性硬化症的老年人提供综合治疗，这些老年人受到衰老和多发性硬化症重叠症状的独特影响（如虚弱、跌倒、功能衰退、多种并发症、多种药物治疗、认知障碍、营养缺陷、获得医疗保健的障碍）。诊所招募了多学科专家，并收集了患者的初步满意度结果：诊所的多学科专家团队由一名多发性硬化症高级执业医师、多发性硬化症药剂师、理疗师、神经心理学家、营养师和社工组成。我们设计了一个门诊模板，每位专家在每半天的门诊中为 4 名 60 岁以上的多发性硬化症患者看病。对 25 名参与者进行的初步患者满意度调查显示，绝大多数人都给予了积极的反馈。大多数参与者（92%）都认为门诊组织得很好，92%的参与者认为参加门诊让他们受益匪浅。此外，80% 的参与者表示诊所提高了他们的整体护理质量：多发性硬化症老年门诊为多学科专家团队为多发性硬化症老年人提供全面的老年病评估和护理提供了一种模式。参加门诊的患者的初步反馈表明，护理质量有所提高。

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Implementing a multidisciplinary approach for older adults with multiple sclerosis: Geriatric neurology in practice

Background

Older adults with multiple sclerosis (MS) face unique challenges arising from age-related changes in MS pathophysiology and overlapping geriatric syndromes. There is a need for geriatrics-focused multidisciplinary care for the rapidly growing older MS population.

Objective

To design and implement a geriatric multidisciplinary clinic for older adults with MS.

Methods

We describe the development of a multidisciplinary approach to geriatric MS care within a single institution through the implementation of the Aging with MS Clinic. The clinic model was conceived through collaboration between neurology and geriatric medicine to provide comprehensive care for older adults with MS who are uniquely affected by overlapping symptoms of aging and MS (e.g., frailty, falls, functional decline, multiple comorbidities, polypharmacy, cognitive impairment, nutritional deficits, barriers to access healthcare). Multidisciplinary specialists were recruited to staff the clinic, and initial patient satisfaction outcomes were collected.

Results

The team of multidisciplinary specialists staffing the clinic consists of a MS advanced practice practitioner, MS pharmacist, physical therapist, neuropsychologist, dietitian, and social worker. A clinic template was devised where 4 patients with MS over age 60 are seen by each specialist during each half-day clinic session. Initial patient satisfaction surveys from 25 participants showed overwhelmingly positive feedback. A majority of participants (92%) agreed that the clinic was well-organized, while 92% felt they benefitted from attending. Additionally, 80% of participants reported that the clinic improved their overall quality of care.

Conclusion

The Aging with MS clinic outlines a model for comprehensive geriatric assessment and care in older adults with MS by a team of multidisciplinary specialists. Initial feedback from patients who attended the clinic conveyed improved quality of care.

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.