Implementing a multidisciplinary approach for older adults with multiple sclerosis: Geriatric neurology in practice

Mara Bahri; Kristi Epstein; Erin Stevens; Ashley E Rosko; Sarita Maturu; Yinan Zhang

doi:10.1016/j.msard.2024.105952

Implementing a multidisciplinary approach for older adults with multiple sclerosis: Geriatric neurology in practice

Mult Scler Relat Disord. 2024 Oct 24:92:105952. doi: 10.1016/j.msard.2024.105952. Online ahead of print.

Authors

Mara Bahri¹, Kristi Epstein², Erin Stevens³, Ashley E Rosko⁴, Sarita Maturu², Yinan Zhang⁵

Affiliations

¹ College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
² Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
³ Department of Internal Medicine, Division of Palliative Medicine, The James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
⁴ Department of Internal Medicine, Division of Hematology, The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States.
⁵ Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States. Electronic address: Yinan.zhang@osumc.edu.

PMID: 39489084
DOI: 10.1016/j.msard.2024.105952

Abstract

Background: Older adults with multiple sclerosis (MS) face unique challenges arising from age-related changes in MS pathophysiology and overlapping geriatric syndromes. There is a need for geriatrics-focused multidisciplinary care for the rapidly growing older MS population.

Objective: To design and implement a geriatric multidisciplinary clinic for older adults with MS.

Methods: We describe the development of a multidisciplinary approach to geriatric MS care within a single institution through the implementation of the Aging with MS Clinic. The clinic model was conceived through collaboration between neurology and geriatric medicine to provide comprehensive care for older adults with MS who are uniquely affected by overlapping symptoms of aging and MS (e.g., frailty, falls, functional decline, multiple comorbidities, polypharmacy, cognitive impairment, nutritional deficits, barriers to access healthcare). Multidisciplinary specialists were recruited to staff the clinic, and initial patient satisfaction outcomes were collected.

Results: The team of multidisciplinary specialists staffing the clinic consists of a MS advanced practice practitioner, MS pharmacist, physical therapist, neuropsychologist, dietitian, and social worker. A clinic template was devised where 4 patients with MS over age 60 are seen by each specialist during each half-day clinic session. Initial patient satisfaction surveys from 25 participants showed overwhelmingly positive feedback. A majority of participants (92%) agreed that the clinic was well-organized, while 92% felt they benefitted from attending. Additionally, 80% of participants reported that the clinic improved their overall quality of care.

Conclusion: The Aging with MS clinic outlines a model for comprehensive geriatric assessment and care in older adults with MS by a team of multidisciplinary specialists. Initial feedback from patients who attended the clinic conveyed improved quality of care.

Keywords: Aging; Clinical practice; Geriatrics; Multidisciplinary care; Multiple sclerosis.