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EUROPEAN CHARCOT FOUNDATION
LISBON DECLARATION
European Charcot Foundation Symposium
"Treatment Strategies in Multiple Sclerosis. From pathophysiology to clinical practice"
17 - 19 November 2005
Results from a Round Table Discussion on Rules for individual patient care in MS.
J. Palace (chair), M. Amato, G. Comi, G. Edan
M. Friedrichs, O.R. Hommes
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Introduction
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All MS patients should receive the best available treatment, independent of country
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Education of patients and physicians on MS should continue, supported by Health Care Systems and Pharmaceutical Industry
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Clinical tools to monitor patients should improve
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Post marketing, observational long term studies should investigate efficiency and compliance of treatment
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Full patient information is a prerequisite
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Patient's and doctor's freedom of choice concerning treatment should be preserved
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Individual Patient Care
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MS Health Care should shift its attention from disease orientation to care orientation
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Quality of care should have monitoring tools
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MS doctors should learn from daily practice
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Learning relies on reliable information
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Amount of structured information should increase through network of treating doctors, served by information technology (Blumhardt et al. 2000)
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Improve clinical measurement tools
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Improve MRI skills of MS doctors
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Diagnosis
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Careful exclusion of other diseases by CSF, immunology, neurophysiology
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Make diagnosis as early as possible
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Assess patient's condition
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Categorize individual patient's prognosis for progression
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Categorize individual patient's treatment response
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Disease modifying treatment
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shared decision making by patient and doctor (Heesen 2004)
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define response to treatment (relapse reduction)
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define treatment failure (EJN 2004)
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Management
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Results of Treatment
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Literature
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Blumhardt et al.: A quality network model for the daily care of multiple sclerosis
Multiple Sclerosis (2000) 6, 231 - 236
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Confavreux et al: Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process
Brain (2003) 126, 770-782
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International Working Group for Treatment Optimization in MS: Treatment optimization in multiple sclerosis: report of an international consensus meeting
EJN (2004) 11:43-47
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Heesen et al.: Decisional role preferences, risk knowledge and information interest in patients with multiple sclerosis
Multiple Sclerosis (2004) 10:1-8
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Glossary
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