Assessment and management of cognitive problems in people with multiple sclerosis: A National Survey of Clinical Practice
Assessment and management of cognitive problems in people with multiple sclerosis: A National Survey of Clinical Practice
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DOI：
10.1111/ijcp.13300
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发表时间：
2019-03-01
影响因子：
2.6
通讯作者：
Drummond, Avril
中科院分区：
文献类型：
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作者：
Klein, Olga A.;das Nair, Roshan;Drummond, Avril
诊断为多发性硬化症的人通常有认知问题。然而，目前尚不清楚认知障碍在英国是如何评估和管理的。目的本研究的目的是了解目前MS患者认知功能障碍评估和管理的临床实践，并强调任何国家差异。方法向150家多发性硬化症中心和大型医院发放调查问卷，并通过电子邮件和社交媒体分享在线调查结果。结果对109名医护人员的反馈进行了分析。大约59% （n = 64）的人报告说他们使用认知评估工具：蒙特利尔认知评估（MoCA）是最广泛使用的工具。评估通常由职业治疗师（55%,n = 60）或临床神经心理学家和心理学家（38%,n = 41）完成；当评估显示患者存在认知问题时，49% （n = 53）的应答者制定并实施了认知康复计划；16% （n = 17）表示他们会将患者转介到专科认知康复进行症状管理；3% （n = 3）在提供认知康复方案时遵循手册。结论评估和管理认知问题的临床途径各不相同，取决于卫生专业人员的个人专业知识、可用资源和专科服务的可及性。虽然卫生保健专业人员强调评估和管理的重要性，认知康复方案并没有常规提供在英国。
Background People diagnosed with multiple sclerosis often have cognitive problems. However, it is unclear how cognitive impairment is currently assessed and managed in the UK. Aim The aim of this study was to understand the current clinical practice of assessment and management of cognitive impairment in people with MS and to highlight any national variation. Methods A survey was posted to 150 MS centres and large hospitals and an online version was shared via email and on social media. Results Responses were analysed from 109 healthcare professionals. Approximately 59% (n = 64) reported that they used cognitive assessment tools: the Montreal Cognitive Assessment (MoCA) was the most widely used. Assessments were usually done by occupational therapists (55%; n = 60) or clinical neuropsychologist and psychologists (38%; n = 41); 49% (n = 53) of respondents developed and implemented a cognitive rehabilitation plan when the assessment indicated that patients had cognitive problems; 16% (n = 17) indicated that they would refer patients to specialist cognitive rehabilitation for symptom management; 3% (n = 3) followed a manual when providing a cognitive rehabilitation programme. Conclusions Clinical pathways for assessing and managing cognitive problems vary and are dependent on the individual expertise of health professionals, available resources, and access to specialist services. Although healthcare professionals highlight the importance of assessment and management, cognitive rehabilitation programmes are not routinely offered in the UK.