Best Practices for Encouraging Physical, Emotional and Nutritional Wellness in Patients with Multiple Sclerosis (MS)

Background: Wellness initiatives are fast garnering the attention of healthcare providers and MS patients for managing disease symptoms and improving quality of life. Despite increasing interest, there remains a lack of guidance for providers to help in their patients’ journey to wellness.

Objectives: To report insights from advanced practice clinicians (APC) on best practices surrounding wellness in MS, including identification of key obstacles to achieving wellness and potential solutions for overcoming them, and collaboration with colleagues to promote wellness.

Methods: During a March 2017 advisory board, a panel of 25 APC MS experts from across the US discussed promoting wellness in MS patients.

Results: Wellness comprises emotional, nutritional, and physical components, with emotional wellness supporting nutritional/physical wellness. Challenges to improving wellness include lack of patient motivation and guidance, limited office visit time, feelings of discouragement, financial barriers, and lack of resources. APCs play a central role in helping patients overcome these barriers by facilitating changes in wellness habits, providing instruction on wellness initiatives, and tracking/supporting patient progress. To assess wellness needs, providers can implement interviewing techniques, such as face-to-face interactions, group discussions, or including a family member during office visits. Standardized screening tools can aid in diagnosing depression/anxiety, and blood tests may inform nutritional needs. Wellness interventions incorporate complementary/alternative medicine practices. Interventions to address emotional wellness include mindfulness classes, psychotherapy, group therapy, community involvement through volunteering, use of medications, and stress relaxation tools.  APCs can promote nutritional wellness by educating patients on appropriate food choices, emphasizing the importance of nutrients and hydration, or by referral to nutrition counseling. Physical wellness can be improved by physical therapy, group exercise, developing a personalized exercise regimen, and using smart technology to monitor physical activity. Smoking/alcohol/drug cessation should be persistently encouraged by the APC, with referral to smoking cessation or alcohol/drug counseling programs.

Conclusions: These insights may contribute to the development of best practices in wellness management and aid APCs in guiding patients’ wellness efforts to improve their quality of life.

 Study supported by Sanofi.