#CMSC16 – Novel Model of Home Care for Patients with Progressive MS Proven Beneficial, Increased Patients’ Satisfaction

A new model of care implemented to address the needs of patients with progressive multiple sclerosis (MS) and their caregivers has proven beneficial by reducing hospital stays, avoiding major care expenses, and improving patients’ satisfaction.

The model has been tested in MS patients with high disability scores, and preliminary results of the study were presented at the Consortium of Multiple Sclerosis Centers (CMSC) 2016 Annual Meeting June 1-4 in National Harbor, Maryland. The study, “Multiple Sclerosis at Home Access (MAHA): Care into Community,” was presented by Kathleen M. Healey from the University of Nebraska Medical Center, in the session, “Comprehensive Care in MS and Symptom Management.”

Although major advances have been made in the treatment of MS patients with relapsing forms of the disease, many evolve into a progressive phase of MS, a chronic and debilitating form of the disease that often leads to severe disabilities.

These patients frequently experience life-threatening medical complications and reduced quality of life, and their situation can be a heavy burden for caregivers. In fact, the progressive phase of MS meets the description of a “consuming illness” outlined by the Patient-Centered Medical Home Model (PCMH). Still, patients with progressive MS often face great challenges in accessing healthcare, as well as in coordinating and financing it, revealing the urgent need to develop new models for care delivery for this patient population.

Healey analyzed the results of a house call program implemented in January 2014 at the University of Nebraska/Nebraska Medicine MS Clinic, which serves 21 individuals with progressive MS, with high disability scores, as assessed by Expanded Disability Status Scale (EDSS) scores greater than or equal to 7.5. The model of care included care principles that replicated effective methods already used in home-based care of other populations with functional deficits.

The approach was based on a multidisciplinary team that included primary and specialty care providers aimed at enhancing competency. Communication with caregivers was improved through regular house calls, reducing care access problems, and care coordination was performed by a “comprehensivist,” a provider with training in primary care, particularly in MS care.

According to the team, preliminary results of the study suggest that the implemented model reduced hospital length, avoided expenses, and improved patients’ satisfaction, and might be a better way to support MS patients.