Multiple Sclerosis Multidisciplinary Care: A National Survey and Lessons for the Global Community.

• MS nurses (MSN) and multidisciplinary teams (MDT) may increase MS care quality. • Disparities in MSN/MDT support remain in an accessible health care system. • Building consensus on care quality standards for MSN and MDT in MS is advised. • Recognition and reimbursement of MSN/MDT is needed. Access to, standardization and reimbursement of multidisciplinary care for people with MS (PwMS) is lacking in many countries. Therefore, this study aims to describe the current multidisciplinary care for people with MS (PwMS) in Belgium and identify benefits, needs and future perspectives A survey for PwMS questioned various aspects of MS and viewpoints on care. For MS nurses (MSN) and neurologists, employment, education, job-content, care organization and perspectives were inquired. Descriptive and univariate statistics were performed The PwMS survey comprised 916 respondents with a mean age of 46±12.7 years and 75,4 % of the respondents being female. The majority of the participants had relapsing remitting MS (60.8 %) and the mean patient determined disease steps (PDDS) was 2.0 (IQR=3). 65.3 % and 60.4 % of the PwMS reported having access to a multidisciplinary team (MDT) or MSN. Access to an MSN was associated with more frequent disease modifying treatment (p =.015), spasticity (p =.042) and gait treatment (p =.035), but also more physiotherapy (p =.004), driver's license adjustment (p <.001) and a higher employment rate (p =.004). MDT access was associated with more frequent symptomatic bladder treatment (p =.047), higher physiotherapy rate (p <.001), higher work- (p=.002), insurance- (p <.001) and home support measures (p=.019). PwMS without an available MDT more often indicated that MS care needs improvement (p <.001). MSN's (n = 22) were mainly funded through various budgets, including hospital and neurology practice budgets. Finally, 69 % and 75 % neurologists (n = 62) working without an MSN or MDT stated a need of such support and 61 % agreed that MDT's should be organized at hospital-network level MDT and MSN availability may enhance medical and socio-economic support for PwMS. Guidelines, alignment and reimbursement are needed. [ABSTRACT FROM AUTHOR]