Clinical Pathway for the Diagnosis and Management of Patients With Relapsing–Remitting Multiple Sclerosis: A First Proposal for the Peruvian Population

Abstract

Background: Relapsing–remitting multiple sclerosis (RRMS) is a subtype of degenerative inflammatory demyelinating disease of multifactorial origin that affects the central nervous system and leads to multifocal neurological impairment.Objectives: To develop a clinical pathway (CP) for the management of Peruvian patients with RRMS.Methods: First, we performed a literature review using Medline, Embase, Cochrane, ProQuest, and Science direct. Then, we structured the information as an ordered and logical series of five topics in a defined timeline: (1) How should MS be diagnosed? (2) How should a relapse be treated? (3) How should a DMT be initiated? (4) How should each DMT be used? and (5) How should the patients be followed?Results: The personnel involved in the care of patients with RRMS can use a series of flowcharts and diagrams that summarize the topics in paper or electronic format.Conclusions: We propose the first CP for RRMS in Peru that shows the essential steps for diagnosing, treating, and monitoring RRMS patients based on an evidence-based medicine method and local expert opinions. This CP will allow directing relevant clinical actions to strengthen the multidisciplinary management of RRMS in Peru.

Ocrelizumab for the treatment of relapsing remitting multiple sclerosis: A cost effectiveness study in Peru

“…However, non-SIS a liated patients may require out-of-pocket payments for certain services and medications. Other subsystems, such as the Social Security Health subsystem (ESSALUD) and healthcare subsystems for the Armed Forces and Police Forces, provide healthcare services to speci c populations [7]. Private healthcare subsystems are also available, but they cover a smaller percentage of the population.…”