DX45
The Emotional Impact of an Opportunistic Infection in Multiple Sclerosis Patients Treated with Highly Effective Therapies
Therapeutic management of multiple sclerosis (MS) has dramatically expanded in the last 10 years. Highly effective disease modifying treatments have given patients much optimism as health care providers (HCP) have sought to treat to the concept of no evidence of disease activity. Patients have formed co partnerships with their HCP in discussing efficacy and risks of their mutually agreed treatments. Successful partnership with therapies has enabled patients to resume or maintain a desired quality of life.
Whilst each therapeutic treatment lists rare opportunistic infections in their product information, we are now seeing post marketing increasing numbers of these infections.
In patients where theses infections occur there appears a similar emotional impact to patients initially diagnosed with multiple sclerosis but with the added burden of possible withdrawal of a highly successful therapy or fear of continuation of a therapy.
Objectives: ,
To describe two case of emotional distress post diagnosis of rare opportunistic infections in patients receiving highly effective multiple sclerosis therapies
Methods: ,
Case Studies
Results: ,
- Case study: A diagnosis of cryptococcal meningitis in patient treated with fingolimod: cessation of current therapy and introduction of new therapy
- Case study: A diagnosis of pancolitis in patient during first course of alemtuzumab: Continuation of current therapy
Both cases initial diagnosis and treatment involved multi disciplines such as infectious disease, gastroenterology and neuro-surgery. Once diagnosis and stabilization occurred core themes of distress were evident in both patients.
Conclusions: ,
Our case studies illustrate the emotional distress that diagnosis of rare opportunistic infections in patients treated with highly efficacious treatments can trigger. Patients can experience grief, loss and fear at removal or continuance of a highly successful treatment and require counseling and support. Anger and bargaining with HCP is common. The MS team is crucial to assist not only in the diagnosis and treatment regimes of an opportunistic infection, but key supports in the emotional journey patients face.