The Neuro鈥檚 Multiple Sclerosis (MS) Clinic is critical to the care of some 4,000 patients in Montreal. A multidisciplinary team of neurologists, nurses and therapists treat patients with relapsing-remitting MS as well as with progressive MS. The clinic, which is celebrating its 70th anniversary this year, focuses on treating patients with complex cases.
鈥淚t is about tertiary care,鈥� says Vanessa Spyropoulos, a nurse specialist who, with her nurse specialist colleague, Kathleen Savoy, provides resources and information and makes sure that patients can function on a daily basis and get community resources.
MS is indeed a complex disease.
鈥淢any relapsing-remitting patients do well for years, while others will transform into a more progressive type of MS. Those with progressive MS need more services from the start,鈥� says Spyropoulos. 鈥淥ur goal is to try to maintain patients鈥� independence as much as possible. We encourage patients to learn to put MS in its place in their lives and self-manage their illness. That鈥檚 crucial as this is the care model for chronic illness. A patient comes to clinic every six or 12 months, so it鈥檚 vital that they have the tools and resources to manage between visits.鈥�
It鈥檚 not uncommon for patients to need to adjust their drug regimens over time.
鈥淲e鈥檒l teach them about the particular drug therapy, coordinate the screening process and indicate steps to take before starting a drug,鈥� says Spyropoulos.
The MS Clinic devotes much of its activity to treatment options. A big breakthrough in terms of drug treatments came last year with the approval of ocrelizumab for both relapsing-remitting and progressive MS. It has been shown to be effective in stopping MS progression 鈥� the first such drug to do so. It is the first drug therapy approved for progressive MS, a long-awaited option.
Dr. Douglas Arnold, a physician at the clinic and a MS researcher, played an important role in the development of ocrelizumab.
鈥淲e have 101 patients who started ocrelizumab last year and 43 others are in a screening process,鈥� says Spyropoulos. 鈥淚n addition, each drug has its own patient support program, which is a resource that provides information about the drug and offers support for obtaining reimbursement from public and private insurance.鈥�
The MS Clinic nurses devote nine hours each week to patient phone calls. Patients who call get information about things such as medications and managing symptoms without having to leave the home.
鈥淎 lot of our patients have trouble getting around, so to have this service over the phone is a big help for them,鈥� says Spyropoulos. 鈥淚t also helps us keep up with the workload. We鈥檙e trying to be more efficient because we have a large volume of patients. On 鈥榩hone day,鈥� some patients call with several concerns, which can鈥檛 be tackled all at once. For them, we鈥檒l ask about their main concerns, then book follow up appointments.鈥�
Newly diagnosed patients receive information that goes beyond their medical needs.
鈥淢S touches many aspects of patients鈥� lives, especially young people who in some cases might become too disabled to work,鈥� she says. 鈥淥ur role is to provide access to information and resources, to support patients throughout these challenges. Moreover, about half of all patients will experience depression at some point, so we will often screen for that and if necessary refer them to mental health resources.鈥�
New referrals are usually given appointments quickly, often within a month, according to Savoy. The goal is to help patients remain as independent as possible. They can also participate in clinical trials that are vital in the development of new MS drugs. These trials are coordinated with The Neuro's .
鈥淎s nurses we help empower our patients to take charge of their health through education and support,鈥� says Savoy. 鈥淥ur team is comprised of strong clinicians, enabling the delivery of quality care to our patient population. Chronic illness brings a lot of uncertainty to the patient鈥檚 and their families lives, sometimes making simple decision-making difficult. We try to move the focus onto the patient鈥檚 strengths rather than their weaknesses in order for the patients to gain better control of their health.鈥�
MS Clinic staff :
Dr. Yves Lapierre, Director, neurologist.
Dr. Paul Giacomini, Associate Director, neurologist.
Maura Fisher, physiotherapist
Stephanie Polacco, social worker (starting April, 2019)
Beth Robertson, occupational therapist
Dr. Alex Saveriano, neurologist.
Kathleen Savoy, nurse specialist
Vanessa Spyropoulos, nurse specialist
Maria Angela Costa, administrative assistant
Rosa Russo, administrative assistant
Miriam Testa, medical secretary
