Background:
People with multiple sclerosis (MS) need expert, comprehensive care. However, many people with MS receive care from generalist neurologists rather than from MS sub-specialists, and see primary care providers (PCPs) more often than MS providers. General neurologists have the breadth of knowledge to manage diverse panels; however, do not have depth of MS sub-specialty expertise. People with MS living in rural areas may find it difficult to access care.
The Veterans Affairs Healthcare System (VAHCS) serves ~19,000 Veterans with MS, from young adults recently diagnosed with MS and medically discharged from active service, to older Veterans with advanced progressive forms of MS and multiple comorbidities. Many live in rural areas or small towns. The Veteran population has a high prevalence of PTSD and mental-health conditions.
Objectives: Present an educational program to facilitate collaboration and efficiency among providers of various disciplines caring for MS Veterans. This program must be informed by Veteran culture.
Cover the basics of MS, which focus on differentiating aspects of MS care which may be managed by a local generalist provider and those which are best managed by or in consult with the MS sub-specialist, always with emphasis on the side of caution.
Methods:
A pilot session in the VA-ECHO webinar format ran in the prior year, receiving high satisfaction ratings from the audience. We then planned and presented a multi-part MS VA-ECHO series for 2020-2021. Topics were covered at a basic level and included: MS etiology, demographics and neuroimmunopathology.
MS disease presentation, phenotypes, and diagnostic criteria
DMTs
Symptom management
Wellness and caregiving
Results:
Combined Agree/Strongly Agree ratings as of April 2021:
Content Relevant to Practice: 86.5%
Content will Change Practice: 80.8%
Knowledge Improved: 80.6%
Attendee disciplines
Nursing
Pharmacist
Physical Therapist
Physician
PhD (psychologists; other disciplines)
Speech Language Pathologist
Respiratory Therapist
Dietician
Social Worker
Radiology Technician
MBA/Management
Physician Assistant
Conclusions:
The MS VA-ECHO program is well-received by healthcare professionals from a range of specialties and disciplines.
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