THE OZONE. Views from the frontline of health
By Miranda Olding, MS specialist nurse at the MS Therapy Centre in Bedford. She has a special interest in pain management, and has presented at international conferences. Miranda won an MS Trust ‘Super Nurse’ award in 2013, after being nominated by her patients.
How to move research into practice and the importance of protecting the vulnerable
As MS Specialist nurse in 2017, the biggest challenge I face is both an old and a new problem: how do we ensure research influences practice?
If an ideal standard has been set, we all want to ensure we are meeting it. In MS care, that bar has recently been raised by the launch of the MS Brain Health campaign (http://www.msbrainhealth.org) which has emerged from an evidence-based international consensus report, Brain Health: Time Matters in Multiple Sclerosis.
Its core recommendation is that the goal of treating MS should be to preserve tissue in the central nervous system and maximise lifelong brain health by reducing disease activity. It calls for major policy changes, recommending a more pro-active approach than the current NICE guidelines and standard neurological practice.
Disseminate best practice
Part of that is more active MRI monitoring to detect subclinical disease activity, which will ensure a person with MS (pwMS) can be offered the full range of appropriate treatments.
But how, as a specialist nurse, can I bring this recommendation into practice? If I see a ‘stable’ patient who I feel has subtle disease activity, despite the absence of clinical relapses, how do I ensure those MRIs get ordered? I didn’t say I had all the answers!
Do we influence our local services by inviting key opinion leaders to our area to present their findings? Do we attempt to become a disseminator of these recommendations ourselves? Or do we just go in gung ho, request the ideal standard and see what happens? Watch this space: I’ll let you know how I get on!
Leave no one behind
The second challenge is connected with the emergence of new disease modifying therapies that come with a high monitoring burden. How do we ensure pwMS who have long-term disability, who won’t qualify or benefit from these exciting developments, but whose needs are perhaps more complex, are not forgotten, but supported, and responded to as quickly in their time of need as those on active therapy?
MS Forward View: a consensus for the future of MS services (https://www.mstrust.org.uk/health-professionals/ms-services-nhs/ms-forward-view/ms-forward-view-consensus) recognises this potential conflict, noting that services are being skewed away from those with advanced disease, and highlighting a lack of neuro-rehab services.
We will have to take on the challenge to campaign for access to services for our advanced patients and for the provision of adequate neuro-rehabilitation.
• Miranda is a member of The Ozone, a hand-picked group of health experts brought together by Oyster Healthcare Communications to discuss ideas and share best practice across therapy areas. Follow her on Twitter @painfreeAPS
Read more from Miranda and her fellow panellists in Issue 1 of The Ozone e-magazine.
Published on: February 13, 2017