November 3, 2017
The goals of any program to treat either the relapsing-remitting or the progressive forms of multiple sclerosis (MS) are largely the same: prevent progression, manage symptoms and rehabilitate patients as much as possible. Historically, Johns Hopkins patients with MS have been referred for rehabilitation in a piecemeal fashion. Now, three new Johns Hopkins providers are working to change this paradigm.
“We’re hoping to bolster a comprehensive care model and provide rehab care all in one system,” says Abbey Hughes, a rehabilitation psychologist who specializes in helping MS patients with sleep disorders that often accompany this condition.
The Johns Hopkins Multiple Sclerosis Center, part of the Department of Neurology and Neurosurgery, already offers a variety of services for MS patients to provide continuity of care. To strengthen these efforts, Hughes, along with physiatrist Alexius Sandoval and fellow rehabilitation psychologist Meghan Beier, is forming a link to the Multiple Sclerosis Center from the Department of Physical Medicine and Rehabilitation. The goal is to facilitate additional access and communication between providers for the best outcomes.
“MS is one of the more complicated conditions in medicine,” Sandoval says. “As a rehabilitation physician who takes care of patients with MS, part of my job is to take a 100-foot view and look at everything about the patient’s condition.”
Besides coordinating care with patients who might be struggling with problems as diverse as pain, mobility, cognition and swallowing, he says care for patients with progressive MS changes over time. “Patients might need a cane one year and a wheelchair the year after,” he says. “It’s a lifelong process, and we can help with every stage.”
For Beier, medical concerns may come up during a neuropsychological assessment that could benefit from referral to neurologists at the Multiple Sclerosis Center or to other rehabilitation specialists. “With a multidisciplinary team, I don’t feel like I’m on an island trying to take care of symptoms outside my areas of expertise,” she says. “I can focus on the things I know well, and utilize the channels of care for the other issues that arise.”
“Being able to provide the best care for our MS patients involves coordinating efforts between all their providers,” Sandoval says. “In this model, the rehab team is already playing a very important role.”
Watch Alexius Sandoval and Abbey Hughes discuss rehabilitation, precision medicine and more for patients with multiple sclerosis.
PRECISION MEDICINE AND MS
Using optical coherence tomography, MRIs and other tests, Johns Hopkins researchers are working to validate the discovery of multiple sclerosis (MS) prognostic biomarkers that track and predict the course of an individual’s MS over time. In addition, they are establishing new sets of care recommendations based on how aggressively MS is progressing in an individual.