Integrated multiple sclerosis care: New approaches and paradigm shifts

Wallin, Mitchell T.

doi:10.1682/jrrd.2010.03.0047

Cited by 8 publications

(7 citation statements)

References 17 publications

(13 reference statements)

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“…(); the results reveal a request for a variety of learning activities to promote CPD. This study also emphasizes the cPT's perspective as a vital part of the mutual information flow necessary to promote coordinated patient treatment courses, which is in line with many authors' conclusions (Haggerty et al , ; Gottberg et al ., ; Guthrie et al ., ; Wallin, ).…”

Section: Discussionmentioning

confidence: 98%

Clinical Guidance of Community Physiotherapists Regarding People with MS: Professional Development and Continuity of Care

Normann

Sørgaard

Salvesen

et al. 2013

Physiother. Res. Int.

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The results indicate that cPTs identify participation in authentic movement analysis of a familiar patient as significant for professional development. Vital features are evaluation of the interplay between body parts, exploration of improvement of movement embedded in the OP clinic physiotherapist's explanations, followed by discussion. These elements provide access to dynamic elements in practice knowledge that are available only through first-hand experience and promote clinical reasoning through enhanced reflection during action as well as following action. Such guidance suggests direction for subsequent treatment and may enhance the continuity of care, particularly if the cPTs are experienced. Mutual information flow implementing the cPTs' perspective is requested, as are the use of plain language and supervision of the cPTs handling skills. Professional guidance for cPTs in OP clinics for PwMS should be considered when programmes aiming to develop competency in neurological physiotherapy are designed and when continuity of care for PwMS is discussed. More research regarding potential long-term impact of professional guidance in these clinics is requested.

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Section: Discussionmentioning

confidence: 98%

Clinical Guidance of Community Physiotherapists Regarding People with MS: Professional Development and Continuity of Care

Normann

Sørgaard

Salvesen

et al. 2013

Physiother. Res. Int.

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“…11 Telehealth is an important tool for the VA Multiple Sclerosis Centers of Excellence (MSCoE), where many patients are separated from specialty clinics by distance and disability. 12 The purpose of this study was to evaluate the feasibility of implementing a disease-management protocol delivered via a home telehealth program in the VA health-care DC. The self-report-based rating was used in Seattle.…”

Section: Methodsmentioning

confidence: 99%

Clinical Management of Multiple Sclerosis Through Home Telehealth Monitoring

Turner

Wallin

Sloan³

et al. 2013

International Journal of MS Care

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This study examined the feasibility of using home telehealth monitoring to improve clinical care and promote symptom self-management among veterans with multiple sclerosis (MS). This was a longitudinal cohort study linking mailed survey data at baseline and 6-month follow-up with information from home telehealth monitors. The study was conducted in two large Department of Veterans Affairs (VA) MS clinics in Seattle, Washington, and Washington, DC, and involved 41 veterans with MS. The measures were demographic information and data from a standardized question set using a home telehealth monitor. Participants reported moderate levels of disability (median Expanded Disability Status Scale [EDSS] score, 6.5) and substantial distance from the nearest VA MS clinic (mean distance, 93.6 miles). Of the participants, 61.0% reported current use of MS disease-modifying treatments. A total of 85.4% of participants provided consistent data from home monitoring. Overall satisfaction with home telehealth monitoring was high, with 87.5% of participants rating their experience as good or better. The most frequently reported symptoms at month 1 were fatigue (95.1%), depression (78.0%), and pain (70.7%). All symptoms were reported less frequently by month 6, with the greatest reduction in depression (change of 23.2 percentage points), although these changes were not statistically significant. Home telehealth monitoring is a promising tool for the management of chronic disease, although substantial practical barriers to efficient implementation remain.

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“…Because well-validated measures have been developed to test cognitive dysfunction in MS, bringing these measures to a patient's home could circumvent mobility challenges. The automated neuropsychological assessment metrics (ANAM-MS) 3 and symbol digit modalities test (SDMT) 4 are commonly used to assess cognitive function in MS. 2,[5][6][7] Given its focus on patient-centered care within an integrated healthcare system, 8 the Veterans Health Administration is uniquely positioned to implement programs and conduct research on various aspects of telemedicine-enabled care delivery including remote cognitive assessment. The Department of Veterans Affairs (VA) MS Center of Excellence utilizes clinical video telehealth (CVT) to conduct medical center-tohome and medical center-to-community-based outpatient clinic visits with patients.…”

Section: Introductionmentioning

confidence: 99%