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Re-shaping the management of multiple sclerosis

Mhairi Coutts, MS Nurse at the Douglas Grant Rehabilitation Centre in Ayrshire, discusses a new initiative to encourage people with multiple sclerosis to regularly engage with their specialist services

Multiple sclerosis (MS) is a neurological condition characterised by demyelination (damage to the protective covering that surrounds nerve fibres in the brain, optic nerves and spinal cord) and progressive disability. It’s the most common condition of the central nervous system amongst young adults, affecting over 100,000 people in the UK.1 Notably, a study has suggested that Scotland is amongst the highest risk nations for MS in the world,2 with 209 people per 100,000, including a particularly high prevalence in the north of Scotland (229 in Aberdeen, 295 in Shetland and 402 in Orkney).3 The exact cause of this regional variation is unknown.

Due to the complexity of MS symptoms and an evolving management landscape, it is important for people living with MS to regularly engage with specialist services to ensure their condition is being managed in the best possible way, even when the disease does not appear to be active. MS nurses play a crucial role here; regular contact enables us to build trust with patients so they feel able to have open and honest conversations about how they are feeling, which in turn helps us advise on the best management options and possibly identify potential relapses.

Despite this, research has found that one in 10 people living with MS had seen neither an MS-specialist nurse nor neurologist in the past year.4

At the Douglas Grant Rehabilitation Centre (DGRC), we offer patients across Ayrshire and Arran in Scotland an annual review with a member of the multi-disciplinary team (MDT). Accessing MS services regularly makes sure patients are making decisions about their disease management based on the latest facts and information.

To try and tackle this issue, on World MS Day this year we launched a local disease awareness campaign, 1MSg (One Message), which aims to encourage people living with MS to engage in regular and quality contact with our MS specialist services. The campaign uses local media, posters and flyers in GP surgeries and digital adverts to raise awareness of our MS services for people living in Ayrshire and Arran who have MS.

The 1MSg campaign also aims to increase awareness of the MS service to other health and social care professionals, both in primary and secondary care, as they may have patients under their care who are not presently known to us. Using the referral template provided as part of the campaign they can contact us for expert advice or refer to our service. The posters and flyers were sent to a wide range of healthcare professionals and carers across Ayrshire and Arran who may encounter someone with MS, including: GPs, district nurses, pharmacists, optometrists, care homes and peer support groups.

Though early days, we’re already starting to see referrals coming through and a number of GPs have committed to sharing details about our service with all their registered MS patients. This is so encouraging as it demonstrates we’re getting the message out to patients, carers and colleagues across the region to help those living with MS receive the specialist support available to them.

To learn more about the 1MSg campaign, visit The 1MSg is a nationwide campaign and was initiated and funded by Biogen.

1.MS Trust. What is MS? Accessed via: Last Accessed: July 2019.

2.Kearns, PKA. Paton, M. O’Neill M. Regional variation in the incidence rate and sex ratio of multiple sclerosis in Scotland 2010–2017: findings from the Scottish Multiple Sclerosis Register. J Neurology. 2019.

3.MS Trust. Prevalence and incidence of multiple sclerosis. Accessed via: Last accessed: July 2019.

4.GEMSS Patient Survey Meta-Analysis. MS Trust. November 2015. Available at: Last accessed: July 2019.

Mhairi Coutts, MS Nurse at the Douglas Grant Rehabilitation Centre in Ayrshire