Times have changed. Multiple Sclerosis used to be a disease with very little treatment options and a progressive ability to severely disable those affected by it. Within the last five to six years, new drug therapies have proven to be making major inroads in slowing the progression of the disease and in some cases resulting in no evidence of disease activity. However, with these new drugs come a higher risk profile and the need for greater monitoring.
Victoria neurologist, Dr. Olinka Hrebicek’s saw this shift in treatment and decided it was an opportune time to establish a Virtual Multiple Sclerosis Clinic that was fully integrated with the MS Clinic at Royal Jubilee Hospital in Victoria. The clinic connects patients outside of the Victoria area through Telehealth with needed resources. Dr. Hrebicek submitted a proposal to the SSC Quality and Innovation Initiative and received funds to carry on this work.
The Virtual MS Clinic is the first of its kind in Canada and offers complementary care to the Victoria Clinic. Beginning in Parksville in 2014, other ‘mini-satellite clinics’ are now established in Port Hardy and Tofino. At all sites, there are nurses available and neurologists can be connected through Telehealth.
Dr. Hrebicek notes “The number of clinic patients have doubled in the last 10 years with many patients living in the central and north island. There needed to be more nursing and medical resources for these patients and it seemed best to bring the care closer to where the patients are living.”
There are approximately 1800 to 2000 MS patients living on the Island, with at least 650 of these patients living outside of the Victoria area. The MS patient journey on the island begins at the MS clinic in Victoria – that is where detailed assessments take place to establish a baseline.
From there, the journey can vary significantly based on a number of factors: 1) the disease’s progress, 2) the treatment choice – options are usually more effective when the disease is caught early, and 3) the follow-up care needed based on progression and treatment.
An increased number of patients are being put on the “gold standard” therapy, which is drug-based treatment. However, a number of issues could complicate care, particularly when the patient doesn’t live near resources and support. This is where the Virtual MS Clinic has made great strides.
Many patients have said it is difficult to travel to Victoria, especially over the Malahat in winter and with the ongoing construction and congestion around Victoria. “The difficulty in getting to the Victoria clinic has made it harder for some patients to stay on medications if they have complications”, says Dr. Hrebicek.
By providing resources closer to home, MS patients are more likely to adhere to their treatment, more likely to follow-up if there are issues and are better able to cope with the disease and its changing care needs.
Historically, it was not unusual for patients with aggressive MS to become wheelchair-bound. With the prevalence of new and highly effective drug therapies, and by making them more accessible, it is expected that most patients will not become disabled enough to end up in a wheelchair.
Thanks to the Virtual MS Clinic providing care, support and resources closer to an MS patient’s home base, the chances of a life well lived for many MS patients living outside of Victoria has significantly increased.