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Blog: TherigySTM Multiple Sclerosis Patient Care Plans

TherigySTM’s new streamlined patient care plans can help clinicians more effectively monitor and manage patients diagnosed with multiple sclerosis. The new care plans offer a variety of ways of making sure the clinician can capture and ensure patient safety and appropriateness while improving outcomes and quality of life for the patient.

 

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is a chronic, typically progressive disease in which the immune system attacks the protective myelin sheath that covers nerve fibers. This damage causes communication problems between the brain and the rest of the body. Symptoms may include numbness, impairment of speech and muscular coordination, blurred vision, and severe fatigue. Eventually, MS can cause permanent damage or deterioration of the nerves.

 

How many people are affected by Multiple Sclerosis?

The National MS Society estimates that nearly a million people in the United States are living with the disease. The society also estimates that approximately 200 new cases are diagnosed each week in the United States.

People with MS may also develop:

  • Fatigue
  • Numbness or tingling
  • Pain
  • Muscle stiffness or spasms
  • Problems with bladder, bowel, or sexual function
  • Mental changes, such as forgetfulness or mood swings
  • Depression
  • Vision problems

 

How do TherigySTM’s Multiple Sclerosis Patient Care Plans enable clinicians to help manage and monitor MS patients?

TherigySTM’s MS Patient Care Plans enable clinicians to help, evaluate, manage, and monitor MS patients towards positive outcomes. These include slowing disease progression by monitoring adherence to medication, reducing any associated side effects of the medication, and utilizing industry-standard patient-reported measures to help improve quality of life.

Goals of therapy for patients with MS include:

  • Slow progressive MS
  • Reduce frequency and severity of relapses
  • Decrease long-term disability
  • Minimize changes in memory and thinking
  • Improve overall quality of life
  • Treat and improve symptoms of MS
  • Mitigate side effects of MS treatment

TherigySTM’s MS Patient Care Plans also allow clinicians to measure the quality of life of the MS patient through standard questions embedded in the care plans that address missed days of school, work, or social activities, the number of times the patient sought urgent care, and the patient’s own description of their quality of life.

The outcomes listed below are captured through various questions in the chart review, patient education, and counseling sections. These outcomes are from a recent study regarding what MS patients find the most beneficial when it comes to therapy management. (Source: Day GS, Rae-Grant A, Armstrong MJ, et. al. Identifying Priority Outcomes that Influence Selection of Disease-Modifying Therapies in MS. Neurology: Clinical Practice. June 2018;8(3):179-185.)

Outcomes:

  • Number of relapses
  • Proportion of patients with relapses/those without
  • Time to first relapse while on treatment (CIS)
  • Annual relapse rate (# of relapses per patient-year during treatment)
  • Decrease in disability progression (EDSS and PDDS)
  • Number of adverse events
  • Improved QoL (Health and Productivity)

Patient care plans are broken up into clinical onboard, clinical initial, and clinical follow-up activities that include the patient’s past medication history, diagnosis dates, and more. Let’s take a deeper look at the clinical onboard portion of the patient care plans.

 

MS Patient Care Plan Highlights:

Notable highlights of TherigySTM’s MS patient care plans include:

  • a review of the patient’s past medication history, including specific reasons for discontinuation. Patient discontinuation reasons are an excellent tool for understanding how to guide therapy toward what the patient’s insurance will cover, what goals the patient may have regarding family planning, and other issues such as adherence or side effect tolerance.
  • insight into the patient’s diagnosis date regarding when they started treatment and their treatment plan. For example, we know that if a patient is diagnosed much later on in life with MS, their disease is much more aggressive and could be harder to treat. They may experience more relapses that leave them more debilitated. 
  • treatment duration can provide insight into any delay in starting therapy, such as cases where the patient was planning a family or if the patient was part of the "watch and wait" non-treatment modality.
  • family planning chart review allows the clinician to capture if the patient is family planning, the results of pregnancy tests if needed, and if the patient is using adequate contraception. Knowing the patient’s current and future plans can help guide therapy towards positive outcomes.
  • Because MS drugs are immunomodulators, knowing the patient’s concurrent infections status with JC virus which causes further demyelination, tuberculosis which is an opportunistic infection, and varicella which can be reactivated with a lowered immune system will give insight into patient management and treatment.
  • drug review houses all of the patient and drug precautions with links to specific areas of the drug package insert that may need to be reviewed by the clinician. This is applicable to only the drug selected and provides information on the first injection and device training, and pre-medications suggested by the manufacturer.
  • the monitoring section contains a distinctive data point that captures if the patient has experienced a relapse since last speaking with you and addresses side effects, management, and disease progression as measured by EDSS or the expanded disability standard along with the patient determined disease (PDDS) steps – a patient-reported tool of disability in MS that can be conducted via patient mobile messaging.
  • analytics and reporting include reports to help support accreditation, show pharmacy growth and productivity, and the AE dashboard which can be used to observe the kind of AEs noted by patients. These reports can be customized based on how the pharmacy uses TherigySTM. Future development of the outcomes report will include the unique clinical points related to bleeding, Hepatitis B, and other therapeutic categories.

To learn more about the Multiple Sclerosis clinical care plans and the capabilities of TherigySTM, contact us for more information.