Editorial - Volume 17, Issue 4 - July 2015

I recently spent a few days in the beautiful Québec province of Canada, and was struck by how everybody I interacted with was ready to switch between French and English, so visitors could communicate in the language they were most comfortable with. While I will not pretend that I fully understand the cultural, societal, and political implications of the cohabitation of francophones and anglophones in Canada, I couldn't help but draw a parallel with multidisciplinary MS care. Each discipline has its own “jargon,” which may at times sound like a foreign language to members of another discipline. Yet, fueled by a common mission to enhance the quality of life of individuals who place their trust in our hands, we commonly overcome this barrier to communicate with other members of the care team. It is my hope that the articles published in the International Journal of MS Care contribute to better communication among all MS care professionals, to the ultimate benefit of our patients.

In this issue, Leary and coauthors illustrate the essential role of our nursing colleagues in a retrospective service evaluation in the United Kingdom, by showing how proactive management of MS patients' needs, including a rapid response service and the implementation of a care pathway in the emergency department, led to a substantial decrease in the number of emergency room visits and acute inpatient bed utilization. Further demonstration of the impact of nursing care is provided by Caon and colleagues, who show how nursing management affected the detection and management of infusion-related reactions in two phase 3 randomized clinical trials of alemtuzumab in relapsing-remitting MS.

Three articles in this issue, while mainly focused on physical therapy, provide new information that is relevant across disciplines. In the era of value-based care, selecting appropriate outcome measures is critical, yet clinicians may have difficulty choosing from the growing number of instruments proposed in the literature. Cohen and colleagues demonstrate, through case studies, how recommendations from the Multiple Sclerosis Outcome Measures Task Force of the American Physical Therapy Association can be applied in clinical practice. Further illustrating the clinical utility of standardized assessment tools, Mazumder and colleagues confirmed the factorial structure of the Falls Efficacy Scale–International (FES-I), and found that fear of falling was associated with recurrent falls in the following 3 months. The meta-analysis completed by Block and colleagues demonstrated a significant effect of physical therapy on incontinence and quality of life, although further research is needed to test the various interventions proposed, and to understand the mechanisms explaining clinical efficacy findings.

The unpredictability of the course of MS presents a challenge to clinicians, and an even greater challenge to those who are trying to adjust to the consequences of this “uninvited guest.” The review from Alschuler and Beier explains how “intolerance of uncertainty” may influence the coping profile of individuals with MS. Greater intolerance of uncertainty may result in increased stress and emotional suffering, but coping skills can be improved through available therapeutic options.

Last but not least, Dobos and colleagues draw our attention to the fact that women with severe physical disability resulting from MS are less likely to undergo routine preventive health screenings recommended by the Centers for Disease Control and Prevention, compared to women in the general population. This is particularly concerning because immobility increases the risk of developing some of these common comorbidities, and recently published evidence shows that comorbidities negatively affect MS patients' functional status.

Finally, I am pleased to report that the journal has won two publishing awards in 2015: an APEX Award for Publication Excellence and a Hermes Creative Gold Award. These awards are given for excellence in professional communications, and we appreciate these signs of recognition of our accomplishments by the media profession.

I want to express my gratefulness to our authors, reviewers, editorial board members, editorial staff, and readers for helping the IJMSC fulfill its mission. At the same time, I count on all of you to help optimize the visibility of our journal within the worldwide community of MS care providers. As always, I wish you pleasant reading, and I invite you to provide feedback and comments, via email or social media.