Posters
Indentifying cognitive impairment – the development of the Multiple Sclerosis Quality Living (MSQL) screen
Jane Bradshaw, Lead Nurse Specialist in Neurology, Norfolk PCT; Nadina Lincoln, Prof of Clinical Psychology, University of Nottingham. Chris Manning, Chief Executive, Primhe, London. Susan Mitchell, GP Lead for Neurology, Pro-Active Care Team (NeuroPACT), Surrey; Dawn Reeve, Clinical Neuropsychologist, Nottinghamshire Healthcare NHS Trust, Mansfield; Anita Rose, Clinical Psychologist, Walton Centre of Neurology and Neurosurgery, Liverpool. Jane Ware, MS Specialist Nurse, Southampton General Hospital; Margaret White, Speech and Language Therapist, Clinical Lead for Progressive Disorders, Mansfield Community Hospital. Adam Zeman, Professor of Cognitive and Behavioural Neurology, Peninsula Medical School, Exeter;
In June 2007 a group of healthcare professionals with a strong interest in and/or practical experience of cognitive problems in people with multiple sclerosis (MS) met. The purpose was to explore how screening for cognitive impairment could be encouraged as part of the routine clinical management of people with MS.
The main outcome from this meeting was the development of a new survey/screening tool, the Multiple Sclerosis Quality Living (MSQL) screen. The MSQL asks people with MS, their carers and health professionals to indicate the level to which MS has affected physical, psychological/cognitive and social functioning. People with MS, carers and health professionals are asked to rate the severity, from 'not affected' to 'severely affected'.
The MSQL has been developed in two parts, a 'global' MSQL and a 'cognitive' MSQL. A pilot survey was undertaken, following an approach to the National Research Ethics Service who deemed that ethical approval was not required under NHS research governance arrangements for this work.
This poster presents a number of interesting observations from the 'global' MSQL survey. The visual nature of the MSQL helps health professionals to identify aspects of life affected by MS rapidly. Initial results from the pilot survey support the group's view that screening for cognitive impairment should be part of the routine review of people with MS, and that the MSQL may help. Patients' ratings of how they are affected by their condition often differ from the healthcare professional's perceptions. The degree to which they differ is dependent on factors including the sex of the patient. Similarly, patients' ratings also often differ from the carer's perceptions.
The 'global' MSQL is intended to provide an aide-memoire for health professionals, helping to enquire in a systematic manner about the domains of functioning that can be affected by MS. It was not felt to be practical or necessary, to validate this part of the MSQL which is based on clinical experience and has been refined with use. It is planned to validate the 'cognitive' MSQL against standard psychometric measures.
* The convening of the working party and the concept of the MSQL was stimulated by Innervate Ltd. Funding for the work of the group and the development of the MSQL has been provided thanks to sponsorship from Biogen Idec.