It affects myelin, the white matter of the central nervous system, causing neurological disorders that can vary depending on the neurological pathway involved. And the multiple sclerosis, a pathology that can cause damage to the myelin in multiple locations and times, which is why it is called ‘multiple’. It generally begins between the ages of 20 and 40, but it can also affect children and the elderly. It is the leading cause of neurological disability in young adults, except for trauma. THE most frequent symptoms, especially in the onset phase of the disease, are sudden reduction or loss of vision in one eye or lack of strength and / or sensitivity in one or more limbs. Less frequently the following can be found: double vision, disturbances in balance, coordination and urinary function. Monitoring of these patients is essential, even remotely as was the case during the pandemic.
Valuable help for people with MS came from the project ‘Viva’ (Virtual Visit and Assessment), promoted by Novartis in the neuroscience area, an innovative model for the remote monitoring of patients with multiple sclerosis, based on the execution of virtual neurological check-ups. The course of multiple sclerosis is, in most cases, of the remitting-relapsing type, that is characterized by an alternation of relapses and recoveries, less and less complete over time. The consequences can be very serious and, to limit them, therapeutic intervention is increasingly urgent.
“If the disease is not promptly and adequately treated, a progressive and irreversible accumulation of neurological disability occurs. 50% of patients with a natural history of disease (ie not treated) will need at least one support to walk within 10-15 years. Early and correct diagnosis and regular check-ups are therefore essential in MS patients. Given the increase in the number of patients, the complexity of management, the frequent need for follow-up visits and the limited availability of outpatient visits in some settings (not least during the Covid-19 pandemic), there is therefore a need objective of innovative management models ”, he says Roberto Bergamaschi, Director of the Multiple Sclerosis Unit and head of the Multiple Sclerosis Research Center at Irccs Mondino Foundation of Pavia, in an interview published on the Aleati per la Salute website (www.alleatiperlasalute.it) the portal dedicated to medical-scientific information created by Novartis.
Bergamaschi therefore underlines the need to develop a remote telemonitoring model that allows, through virtual neurological control visits, the assessment of the level of disability of the patient suffering from multiple sclerosis and the continuous verification of any worsening. “Through ‘Viva’ – explains Bergamaschi – in addition to testing the patient’s neurological performance, it is possible to follow the clinical evolution of the disease, monitor the effects and tolerability (and the possible occurrence of adverse events) of therapies. These findings make it possible to identify the onset of symptoms early, recommend examinations, modify therapies accordingly, plan improvement interventions, involving, if necessary, the caregiver, specific professionals and local services “. The new model therefore envisages obtaining a broad picture of the patient’s conditions and his / her therapeutic path, in order to favor greater effectiveness of the treatments.
The ‘Viva’ project was developed taking into account various aspects, including: measurement and sizing of patient flows by type of outpatient activity; criticality analysis and detection; breakdown of the management processes of neurological visits (activities, actors, roles, support tools); assessment of the medico-legal implications and guaranteeing privacy of the new way of doctor-patient interaction, in the event of critical issues in the patient’s care and treatment path. Bergamaschi has no doubts: “The implementation of a new model for carrying out virtual visits guarantees a series of benefits to all the actors involved in the management process of the patient with MS”.
For the expert, from the point of view of patient and caregiver, travel and social costs deriving from transport and absences from work are reduced. Furthermore, environmental comfort is increased, thanks to the possibility for the patient to stay at home, and the risk of contagion from Covid-19 is lowered while maintaining a perception of closeness with the neurologist. For the hospital, on the other hand, remote monitoring makes it possible to reduce the flow of patients, with a reduction in waiting lists, without giving up the continuity of taking charge. The expert’s intervention is available on: https://www.alleatiperlasalute.it/salute-20/telemedicina-nuovo-opportunita-con-il-modello-viva.