EDITORIAL

Abstract

As we return to our usual lives after another exciting and educational annual meeting of the Consortium of Multiple Sclerosis Centers (CMSC), the International Journal of MS Care (IJMSC) returns as well to its usual spectrum of articles covering the range of issues confronted by multiple sclerosis (MS) professionals. While the Spring 2011 issue focused on the theme of mobility in MS, the current issue reflects the breadth of concerns that we face in caring for MS patients. Highlighted on the cover is an excellent article on meeting the needs of people with primary progressive MS (PPMS) and their families by our colleagues at the National Multiple Sclerosis Society (NMSS) and the Multiple Sclerosis Association of America (MSAA). The CMSC, which sponsors the IJMSC, has joined with the NMSS and the MSAA along with several other organizations to form the MS Coalition, and we are therefore particularly honored to publish this important piece, in which Dr. Holland (formerly with the NMSS), Dr. Kalb, and colleagues describe a collaborative effort by the NMSS and the MSAA to analyze and address the needs of people with PPMS, who have often felt neglected by the MS community. The authors point out that treatment strategies for this group of patients have focused on managing the symptoms of the disease and providing counseling and other forms of psychosocial support in which the MS nurse plays a particularly large role.Ms. Hoogs and colleagues from the Jacobs Neurological Institute of the State University of New York at Buffalo also tackle a sometimes neglected area in MS care: the connection between cognition and physical disability. Their study highlights the association between cognition and health-related quality of life, which points to the broad impact of cognitive impairment and the importance of its early identification in the comprehensive care of MS patients. We hope that future issues of the IJMSC will address treatment strategies in this important area as we learn more about the problem.Continuing our serendipitous “theme” of potentially neglected topics, Dr. Attarian and colleagues from Loyola University in Chicago, the Universities of Vermont and Michigan, and Harvard University address the need for restful sleep in MS patients. Their study examined the effect of eszopiclone on sleep disturbances and daytime fatigue in MS patients. Their work highlights not only the need to improve sleep in MS patients but also the complicated nature of fatigue in MS, as improved sleep generally did not eliminate daytime fatigue in the study participants. Ms. Todd and Dr. Stuifbergen of the University of Texas at Austin, in their study of barriers and facilitators related to breast cancer screening in women with MS, address the reasons why MS patients often neglect their health apart from their MS. Their examination of the multitude of difficulties—both physical and psychological—that MS patients face in obtaining regular breast cancer screening is enlightening, and they offer several useful suggestions for overcoming these hurdles.Dr. Buchanan and colleagues from Mississippi State University and Indiana University examine the role of informal caregivers in the lives of MS patients. All of us have seen patients whose informal caregivers suffer significantly in providing the best care that they can, and this article highlights the importance of addressing these care-givers' burden levels and mental health needs and helping them obtain support.We are also pleased to publish an article in an area that the IJMSC seldom addresses: the practicalities of MS practice. Dr. Foley of the Rocky Mountain Multiple Sclerosis Clinic in Salt Lake City, Utah, and Ms. Dunne of Grassi & Co in Jericho, New York, examine the management of an in-office infusion center, which allows increased contact of patients with their primary MS care providers as well as constituting a potential source of revenue with which to maintain the MS practice in an era of continually rising costs and decreasing reimbursement. This article reminds us that without a financially viable practice model, we will not be able to provide the care that our patients deserve. Finally, Dr. Avila-Ornelas and colleagues at Baylor College of Medicine in Houston report on their study of the use of intravenous corticosteroids to reduce the risk of postpartum relapse in women with MS. They found that administration of methylprednisolone immediately after delivery reduced the percentage of patients having relapses during the first postpartum trimester but not over the second and third trimesters.Whether or not you were able to attend the CMSC annual meeting in Montreal, we hope that you will find useful the CD that accompanies this issue, which contains abstracts from the wonderful spectrum of presentations at the meeting. This electronic supplement was once again generously supported by an educational grant from Bayer HealthCare Pharmaceuticals, Inc. We invite your submissions of research or reviews relevant to MS professionals and wish you a good summer.