NICE issue updated guidance for treatment of MS

By The Press Association8th October 2014News EnglandGuidance, Multiple Sclerosis, News England

The tens of thousands of people living with multiple sclerosis (MS) should have their condition and treatments reviewed more regularly, according to new guidelines.

The updated guidance for the NHS from the National Institute for Health and Care Excellence (Nice) said sufferers should have a comprehensive review of all aspects of their care at least once a year.

Other key recommendations for healthcare professionals to follow include referring people with suspected MS to a consultant neurologist and offering sufferers an appropriate single point of contact to speak about their care, concerns and different treatment options.

Nice also suggested multidisciplinary teams made up of experts including neurologists, MS nurses, GPs, psychologists, speech and language therapists, occupational therapists, and physiotherapists should oversee care.

People with MS should also be encouraged to exercise and be offered supervised exercise programmes for those who struggle with mobility and fatigue.

Currently, those with MS can be left for more than a year without having their condition and medication monitored but the updated Nice guidance aims to ensure that people with MS have their condition and treatments reviewed more regularly.

Dr Paul Cooper, consultant neurologist at the Greater Manchester Neuroscience Centre and chairman of the Guideline Development Group (GDG), said currently some people are receiving “excellent care and support” but others around the country are not.

“The care someone receives should not depend on where they live, we want to ensure that throughout the country people with this distressing and disabling disease have prompt access to specialists who understand their needs and can help improve their condition,” he added.

The life-long condition of the central nervous system affects both the brain and spinal cord. Its causes are complex and not completely understood and there is currently no cure.

Typical early symptoms include, limb weakness, lack of coordination, loss of sight, and bladder and bowel problems, which usually develop in sufferers’ twenties.

Rates of MS vary with latitude: It is more common in Europe than in the Tropics, and affects more northerners than southerners in the UK.

Professor Mark Baker, clinical practice director at Nice, said: “About 100,000 people in the UK have MS, with symptoms usually appearing in younger people. It can be a highly disabling condition that people live with for many years.

“MS can significantly affect a person’s quality of life: they may have to give up work and may also struggle with their mobility. We know that people with MS tend to die earlier than others. This is why it is important to give people access to the best treatments and specialists who can help them live as normal and as long a life as possible.”

The Nice guidance does not recommend taking fampridine or the cannabinoid drug Sativex, with the CDG advising that there are better treatments available already on the NHS.

Dr Cooper added: “The substantial cost of sativex and fampridine compared to the modest benefit does not justify their use; there are better ways to improve care for people with MS.”

Professor Karen Middleton, chief executive of the Chartered Society of Physiotherapy (CSP), said: “We welcome these guidelines and in particular the emphasis on how exercise can improve quality of life for people with MS and slow the progression of the disease.

“More physiotherapists must now be allowed to use their expertise in movement to devise and deliver those exercise programmes across the country.

“Focusing on preventative services in this way will reduce hospital admissions and enable more people to manage their own condition living independently at home.”