Scope of Clinical Guideline: Multiple sclerosis
Scope of Clinical guideline - Multiple Sclerosis
Final Version
| 1. | Preamble | ||
| The National Institute for Clinical Excellence is responsible for developing, disseminating and giving advice on the implementation of clinical guidelines to provide advice on best practice for patients and health professionals in the NHS in England and Wales. | |||
| 2. | Title | ||
| The management of Multiple Sclerosis (MS) in primary and secondary care in the NHS. | |||
| 3. | Summary | ||
| The guideline will be relevant to adults of all ages with MS and will cover the full range of care that should be routinely made available from the NHS, including appropriate use of mainstream pharmacological, physical therapy, rehabilitative and psychosocial treatments. | |||
| 4. | Status | ||
| This scoping statement has been subject to a period of consultation and discussed with stakeholders. It has been approved by the Guidelines Advisory Committee and the Institute's Guidance Executive and will be posted on the Institute's website along with details of the commission and the developers of the guideline. | |||
| 5. | Issues and Objectives | ||
| 5.1. | Multiple Sclerosis is a progressive neurological condition. It has a variable clinical course and patients present with a variety of problems. They can present with a relapsing/remitting disorder that, after a variable time course, may evolve to a secondary progressive disorder. They may also present with a primary progressive disorder particularly in older patients. | ||
| 5.2. | The guidelines will cover a very broad range of care services, and the developers will need to assess how best to approach this. | ||
| 5.3. | This is an NHS guideline. Although it will comment on the interface with other services, such as those provided by social services and the voluntary sector, it will not include services exclusive to these sectors. | ||
| 5.4. | The guideline will incorporate the Institute's guidance on the use of beta interferon and glatiramer acetate. | ||
| 6. | Inclusions and exclusions | ||
| 6.1. | Disease or condition | ||
| The guideline will be relevant to adults of all ages with MS. The guideline should offer best practice advice on the diagnosis of MS and on the NHS care of patients diagnosed with various forms of MS. Diagnosis, early management, relapsing/remitting and progressive stages of the disease should be considered. Severe and advanced stages of the condition, and the management of rarer symptoms and treatment side-effects will also be covered. Supportive and palliative care will be covered only to the extent that they relate specifically to MS. | |||
| 7. | Health care setting and professions | ||
| 7.1. | The guidelines will cover the care provided by clinician who have direct contact with and make decision concerning the care of patients with MS. It will address the needs of patients and carers in whatever setting NHS care is provided. | ||
| 7.2. | The guidelines the guideline will need to comment on the way health care services need to interact with services provided by Social Services and the voluntary sector but will not seek to guide the practice of social care or services provided by the voluntary sector. | ||
| 8. | Interventions and treatment modalities | ||
| The guidelines will cover the full range of care that should be routinely made available from the NHS, including appropriate use of mainstream pharmacological, physical therapy, rehabilitative and psychosocial treatments. | |||
| These will include | |||
| 8.1. | the diagnosis of the disease | ||
| 8.2. | pharmacological treatments: The guideline will consider the long established and widely used drugs such as steroids (various forms) and azathioprine but the brief specifically excludes evaluation of the beta interferons and glatiramer acetate which are being appraised by the Institute. | ||
| 8.3. | consideration of alternative treatments that might modify disease progress: Although the evidence base is much weaker for these therapies, many patients use them. By considering them, the developers will, amongst other observations, be able to point out where more data may be needed to enable a thorough appraisal of their value. | ||
| 8.4. | prevention of secondary disease processes : including the prevention of pressure sores, contractures, and of incidental diseases that threaten life (e.g. 'flu vaccination) as these pertain to MS. The guideline will take account of the guideline on pressure ulcers | ||
| 8.5. | management of impairments and disabilities :The following will be considered as they apply to people with MS | ||
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| 8.6. | models of care -The guideline will consider evidence on the effectiveness of models of care required to deliver the recommendations in this guideline. | ||
This page was last updated: 30 March 2010
