The Neuro’s 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.
“It is about tertiary care,” 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.
“Many 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,” says Spyropoulos. “Our goal is to try to maintain patients’ 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’s crucial as this is the care model for chronic illness. A patient comes to clinic every six or 12 months, so it’s vital that they have the tools and resources to manage between visits.”
It’s not uncommon for patients to need to adjust their drug regimens over time.
“We’ll teach them about the particular drug therapy, coordinate the screening process and indicate steps to take before starting a drug,” 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 — 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.
“We have 101 patients who started ocrelizumab last year and 43 others are in a screening process,” says Spyropoulos. “In 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.”
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.
“A lot of our patients have trouble getting around, so to have this service over the phone is a big help for them,” says Spyropoulos. “It also helps us keep up with the workload. We’re trying to be more efficient because we have a large volume of patients. On ‘phone day,’ some patients call with several concerns, which can’t be tackled all at once. For them, we’ll ask about their main concerns, then book follow up appointments.”
Newly diagnosed patients receive information that goes beyond their medical needs.
“MS touches many aspects of patients’ lives, especially young people who in some cases might become too disabled to work,” she says. “Our 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.”
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 Clinical Research Unit.
“As nurses we help empower our patients to take charge of their health through education and support,” says Savoy. “Our 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’s and their families lives, sometimes making simple decision-making difficult. We try to move the focus onto the patient’s strengths rather than their weaknesses in order for the patients to gain better control of their health.”
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