LEBANON — Dartmouth-Hitchcock hopes to improve the quality of care for people living with multiple sclerosis, an incurable and debilitating disease of the central nervous system, through a three-year, national multicenter study of 5,000 people with MS.
“MS is a progressive, disabling, costly and incurable disease that can cause a variety of physical and emotional challenges, including fatigue, pain and depression,” said Brant Oliver, the principal investigator of the new Multiple Sclerosis Continuous Quality Improvement Collaborative.
“We are attempting an innovative approach using quality improvement methods to optimize evidence-based care for people with MS at system and population levels,” Oliver said.
Oliver, a Dartmouth-Hitchcock nurse practitioner and assistant professor at The Dartmouth Institute for Health Policy and Clinical Practice and the Geisel School of Medicine, said the program is in the first year of the study to investigate system-level health care performance variation and improvement across participating MS centers.
The goal is to accelerate the rate of improvement in MS care by sharing aggregated data across MS health centers. It is among the first U.S. quality improvement research collaborative studying MS.
Dartmouth-Hitchcock is conducting the study in collaboration with Biogen, a leader in the research and development of treatments for people living with MS.
Participating MS centers include Massachusetts General Hospital’s Multiple Sclerosis Center in Boston; the University of Vermont Multiple Sclerosis Center in Burlington, Vt.; the Multiple Sclerosis Center of Greater Orlando in Maitland, Florida; and the Concord Hospital Multiple Sclerosis Specialty Care Program in Concord.
Four additional sites are expected to join collaborative this year, increasing the total study size to greater than 10,000 people with MS.
“In his role as a Dartmouth-Hitchcock nurse scientist, Dr. Oliver will lead the work of this improvement science research collaborative which aims to improve the quality and value of care for individuals with MS,” said Susan Reeves, chief nursing executive at Dartmouth-Hitchcock.
“This multicenter research program, which is the first of its kind in the United States for MS, is both innovative and timely in that it will bring quality improvement to the MS field, including a rigorous study of geographic variation in care quality and a randomized study of different improvement interventions to optimize outcomes,” Reeves said.
“We hope that through research programs like the MSCQI Collaborative we can meaningfully improve the care of people living with MS,” said Terrie Livingston, senior director of U.S. Medical at Biogen. “By sharing data across centers, we hope to identify effective strategies to improve MS care.”
The collaborative study will evaluate geographic variations in MS care and test the effect of two different system-level quality improvement interventions.
System-level interventions and analyses are performed at higher levels than individual clinicians and patients but at a lower level than population epidemiological studies. Other national quality improvement collaboratives for chronic disease conditions include cystic fibrosis, cardiac surgery and inflammatory bowel disease.
In the first year of this prospective study, participants will be followed to establish baseline performance data. Beginning in the second year of the study, participating centers will be randomly selected to engage in quality improvement interventions for at least two additional years. Investigators will study the impact of quality improvement interventions on a range of patient care and healthcare resource measures, including FDA-approved MS disease-modifying therapy and magnetic resonance imaging utilization. They also will study clinical processes and outcomes such as relapse rate, quality of life, and patient experience.
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