Display options
Cite
Young L, Healey K, Charlton M, et al. A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol. F1000Res. 2015;4:872doi: 10.12688/f1000research.7040.1.
Young, L., Healey, K., Charlton, M., Schmid, K., Zabad, R., & Wester, R. (2015). A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol. F1000Research, 4872. https://doi.org/10.12688/f1000research.7040.1
Young, Lufei, et al. "A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol." F1000Research vol. 4 (2015): 872. doi: https://doi.org/10.12688/f1000research.7040.1
Young L, Healey K, Charlton M, Schmid K, Zabad R, Wester R. A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol. F1000Res. 2015 Sep 18;4:872. doi: 10.12688/f1000research.7040.1. eCollection 2015. PMID: 26673815; PMCID: PMC4670009.
Copy Download .nbib Format: NLM
Share it on

F1000Res. 2015 Sep 18;4:872. doi: 10.12688/f1000research.7040.1. eCollection 2015.

A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol.

F1000Research

Lufei Young, Kathleen Healey, Mary Charlton, Kendra Schmid, Rana Zabad, Rebecca Wester

Affiliations

  1. College of Nursing, University of Nebraska Medical Center, Lincoln, Nebraska, USA.
  2. Multiple Sclerosis Program, Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
  3. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
  4. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA.
  5. Department of Family Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.

PMID: 26673815 PMCID: PMC4670009 DOI: 10.12688/f1000research.7040.1

Abstract

Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden.  Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease. Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention.   Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems.   Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If successful, it will have far-reaching implications in research, education and practice in terms of providing high quality but affordable care to population living with severe complex, disabling conditions.

Keywords: disability; healthcare utilization; home-based care; multiple sclerosis; symptom management; value-based care

References

  1. Am J Psychiatry. 2002 Nov;159(11):1862-8 - PubMed
  2. PLoS One. 2013;8(1):e56676 - PubMed
  3. Mult Scler. 2009 Mar;15(3):385-92 - PubMed
  4. Gerontologist. 1989 Dec;29(6):798-803 - PubMed
  5. J Med Econ. 2010 Mar;13(1):78-89 - PubMed
  6. Health Aff (Millwood). 2009 Jan-Feb;28(1):75-85 - PubMed
  7. Arch Phys Med Rehabil. 2014 Mar;95(3):538-45 - PubMed
  8. Rehabil Psychol. 2012 Nov;57(4):301-7 - PubMed
  9. J Rehabil Res Dev. 2010;47(5):ix-xiv - PubMed
  10. Neurology. 1996 Jul;47(1):129-39 - PubMed
  11. Int J MS Care. 2013 Summer;15(2):99-106 - PubMed
  12. Mult Scler Int. 2013;2013:436929 - PubMed
  13. Mult Scler. 2010 Dec;16(12):1437-42 - PubMed
  14. BMC Neurol. 2012 Sep 18;12:94 - PubMed
  15. Clin Neurol Neurosurg. 2002 Sep;104(4):345-51 - PubMed
  16. JAMA. 1988 Sep 23-30;260(12):1743-8 - PubMed
  17. BMC Health Serv Res. 2013 Sep 09;13:346 - PubMed
  18. Ann Indian Acad Neurol. 2009 Oct;12(4):291-5 - PubMed
  19. Md State Med J. 1965 Feb;14:61-5 - PubMed
  20. Mult Scler. 2007 Jan;13(1):106-12 - PubMed
  21. NeuroRehabilitation. 2004;19(1):55-67 - PubMed
  22. Neuroepidemiology. 2006;26(2):102-7 - PubMed
  23. Neurology. 2013 Jul 30;81(5):470-8 - PubMed
  24. Eur Respir J. 1999 Feb;13(2):449-54 - PubMed
  25. Mult Scler. 2006 Feb;12(1):24-38 - PubMed
  26. Health Aff (Millwood). 2011 Oct;30(10):1947-54 - PubMed
  27. JAMA. 2015 Jun 9;313(22):2296 - PubMed
  28. Mult Scler. 2013 Feb;19(2):217-24 - PubMed
  29. Neurourol Urodyn. 2011 Mar;30(3):395-401 - PubMed
  30. J Neurol Neurosurg Psychiatry. 2008 Sep;79(9):1016-21 - PubMed
  31. Pain. 2013 May;154(5):632-42 - PubMed
  32. Am J Prev Med. 2009 May;36(5):452-7 - PubMed
  33. Eval Program Plann. 1979;2(3):197-207 - PubMed
  34. Neurology. 1991 May;41(5):685-91 - PubMed
  35. BMC Complement Altern Med. 2012 Apr 23;12:50 - PubMed
  36. Mult Scler. 2007 Jan;13(1):67-72 - PubMed
  37. Health Aff (Millwood). 2009 Jan-Feb;28(1):64-74 - PubMed
  38. J Neurol. 1995 Jan;242(2):105-8 - PubMed

Publication Types