Multiple Sclerosis Nursing to Improve Care and Education (MSNICE): an observational study

Objective To explore differences in patient reported outcomes, health care resources and expenditures in persons with multiple sclerosis (pwMS) with or without access to an MS-nurse. Methodology An observational, multicenter and cross-sectional study was conducted. Seven centers with, and twelve centers without an MS-nurse participated. The multiple sclerosis impact scale-29 (MSIS-29) was the primary outcome measure. Secondary outcome measures included: hospital anxiety and depression scale, coping measures, health-economic and disease-knowledge parameters. Results Three hundred thirty-four pwMS were included, of which 196 had access to an MS-nurse. Mean age was 44.5 +/- 11.4 and 69% were women. The median expanded disability status scale and patient determined disease steps were respectively 2.0 (IQR 2.5) and 2.5 (IQR 3). No statistical significant differences between centers with or without an MS-nurse were observed for the MSIS-29 (total) (mean ranks: 169.9 vs. 157.8; Z = -1.114; p = .253), depression (X-2= 1,772, p = .412), anxiety (X-2= 0.446, p = .800) or health expenditures. MS-disease knowledge was higher in patients followed in centers with an MS-nurse than in centers without (17.08(3.37) vs. 15.30(3.39), t(331) = 4.734, p < .001). Conclusion We did not observe clinical differences regarding HRQoL in pwMS between centers with and without an MS-nurse. Yet, we did observe a higher level of MS-specific knowledge in pwMS who had access to an MS-nurse, which may emphasize the important role of MS-nurses in educating and improving self-efficacy and adherence. Belgian registration number B300201421282.