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A network for everyone who works with people with MS to discover, share, support and innovate together. Discover information, research, evidence and innovative ideas to support your work - developed with and by professionals. Follow the link below to go to the MS Society website for more information.

The emotional effects of Multiple Sclerosis often go undiagnosed. It's not unusual to experience depression, stress and anxiety when you have MS. Medication, talking therapies and self-help techniques can all make it easier to cope. This webpage from the MS Society includes information on: depression stress and anxiety causes of mental health problems other mood and behaviour changes coping with losss grief and guilt supporting someone who has MS getting help staying active mindfulness and MS.

In my 15 years focusing on developing drink thickening solutions for dysphagia patients, the intersection of dysphagia management and patient safety has become increasingly apparent. Dysphagia, or difficulty swallowing, presents not only as a significant health challenge but also as a critical patient safety issue. The condition's underdiagnosis, particularly in vulnerable populations, heightens the risk of severe complications, including choking, aspiration pneumonia, dehydration and the profound fear of choking that can lead to malnutrition. The prevalence of dysphagia and its safety implications Dysphagia's prevalence is notably higher among specific populations, with studies indicating rates from 2.3% to over 16% in the elderly and up to 99% in children with severe generalised cerebral palsy and learning disability.[1, 2] These figures underscore the condition's widespread impact, yet dysphagia often remains underdiagnosed and undertreated, particularly in vulnerable groups. Public Health England and clinical research highlight the pressing need for better recognition and management of dysphagia to mitigate its health impacts and address the associated health inequalities.[3] Patient safety concerns The safety risks associated with undiagnosed or poorly managed dysphagia cannot be overstated. Choking and aspiration pneumonia are direct threats to patient safety, with the latter being a leading cause of death in individuals with severe dysphagia. Moreover, the fear of choking can lead to voluntary dehydration and malnutrition, as individuals may avoid eating or drinking to prevent aspiration, further compromising their health and safety. Addressing dysphagia Improving the identification and diagnosis of dysphagia is paramount to enhancing patient safety. This involves: Educational initiatives: Healthcare professionals must be equipped with the knowledge to recognise early signs of dysphagia and understand the associated safety risks. Education should emphasise the critical nature of early detection and the potential consequences of untreated dysphagia, including the increased risk of choking and dehydration. Implementing screening protocols: Systematic screening for dysphagia, utilising tools such as the simple screening tool, 4QT,[2] should be standard practice in healthcare settings. Early detection can significantly reduce the risk of serious complications by facilitating timely and appropriate interventions. Multidisciplinary approach: The management of dysphagia requires a collaborative effort among speech and language therapists, dietitians, occupational therapists, and other healthcare professionals. This team-based approach ensures comprehensive care plans that address both the medical and safety aspects of dysphagia. Enhancing awareness among caregivers and patients: Educating caregivers and patients about dysphagia and its implications is crucial. Increased awareness can lead to better compliance with management strategies, reducing the risk of patient harm. Conclusion Undiagnosed and unmanaged dysphagia is a significant patient safety concern. As healthcare providers, our role extends beyond treatment to include the prevention of complications associated with this condition. By prioritising the early detection of dysphagia and employing a multidisciplinary management approach, we can significantly improve patient safety outcomes. References Tsang K, Lau ESY, Shazra M, et al. A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems? A Pilot Study. Geriatrics, 2020. RCSLT. Dysphagia and eating, drinking and swallowing needs overview. Adkins C, Takakura W, Spiegel BMR. Prevalence and Characteristics of Dysphagia Based on a Population-Based Survey. Clinical Gastroenterology and Hepatology, 2020; 18: 1970-79.

The spread of the Covid-19 pandemic presented significant challenges in the management of patients with chronic diseases like multiple sclerosis (MS). This article in Frontiers in Neurology looks at how telemedicine was used as an alternative to face-to-face consultations with MS patients during the pandemic. Recognising the variation in care that occurred as different centres adopted telemedicine, they make a series of recommendations for the use of telemedicine in managing MS patients. Recommendations are based around the following stages and aspects of care: Triage Appointment Follow-up Nursing Communication

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system of unknown etiology. Bjornevik et al. tested the hypothesis that MS is caused by Epstein-Barr virus (EBV) in a cohort comprising more than 10 million young adults on active duty in the US military, 955 of whom were diagnosed with MS during their period of service. Risk of MS increased 32-fold after infection with EBV but was not increased after infection with other viruses. These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS.

Patients with neurological conditions and their carers are “falling between the cracks” in Scotland’s health system, according to a report from the Neurological Alliance Scotland which suggests two-thirds of the one million Scots living with a neurological condition are struggling to cope. The ‘Today's Challenges, Tomorrow's Hope’ report gathers insights spanning conditions from Alzheimer’s multiple sclerosis, epilepsy and Parkinson’s disease to fibromyalgia, long COVID and cerebral palsy. The report led by the Neurological Alliance of Scotland surveyed Scots about their experiences, finding over half feeling unsupported and 46% said Scotland’s health system ‘does not meet their needs’. People living with cerebral palsy told researchers that while paediatric services are well-established, specialist adults support is largely absent and there is “little care or expertise held within general practice.”

This case report in the journal Cureus examines the use of dalfampridine, a drug used to improve walking in multiple sclerosis (MS) patients. Dalfampridine can have serious side effects including inducing seizures. Although the US Food and Drug Administration (FDA) recommends stopping the medication permanently after a single seizure episode, this recommendation is not widely known by health care professionals. The authors argue that there is a need to raise awareness of the FDA recommendation and the potential for dalfampridine to cause seizures amongst primary and secondary care doctors and patients.