The Consortium of Multiple Sclerosis Centers (CMSC) released a white paper, written by a panel chaired by CMSC member Robert T. Fraser, Ph.D., of the University of Washington Rehabilitation Research and Training Center in Seattle, Washington, analyzing patient self-management in Multiple Sclerosis (MS) to develop recommendations for best practices aimed at improving patients' lives.
An initial literature review revealed that the basis for most self-management intervention techniques is the work of Kate Lorig, RN, Dr.P.H., and her colleagues at the Stanford Patient Education Research Center at Stanford School of Medicine in Palo Alto, CA, who divided patient responsibilities for their own care into three distinct areas: managing medical symptoms, role management (including behavior and daily responsibilities), and managing emotional aspects to their disease. The training involves development of key skill sets such as problem-solving, decision-making, resource utilization, forming patient-provider relationships, action planning, self-tailoring and self-management.
Studies in a similar self-management program in arthritis showed improvement in outcomes measured by reduction in pain and visits to the doctor, and higher self-efficacy, evident in as little as a month after implementation, and sustained for up to 4 years.
The full impact of MS on a patient's life is highly variable and unpredictable. Disease management requires a multidisciplinary approach from a team of trusted healthcare professionals. Patients need to be prepared not only for the changes brought on by the disease itself, but also for the challenges presented by disease-modifying therapies (DMTs) and rehabilitation. The CMSC white paper notes a limited base of study into self-management outcomes in MS patients, despite a tremendous need for such interventions, and reports that techniques are generally limited to patient education, without including the comprehensive range of skill-building and resource acquisition techniques.