Columbia University Clinical Care MS Center Personnel Support
Columbia University Multiple Sclerosis Clinical Care Center
Dr. Mark Tullman
$100,000
The Columbia University Multiple Sclerosis Clinical Care and Research Center, which opened in November 2005 and became affiliated with the New York City Chapter of the National Multiple Sclerosis Society in October 2006, is a comprehensive care facility devoted to the diagnosis and treatment of patients with MS. The center was recently honored to be amongst the first MS centers in the country to be designated a National MS Society-Affiliated Center for Comprehensive Care, which is a new clinical affiliation program that began in October 2009 and focuses on the experience of the patient and emphasizes comprehensive and coordinated MS care.
Columbia has a long history of providing world-class patient care and medical education as well as performing groundbreaking clinical research. In keeping with that tradition, the MS Center provides an ideal environment for individuals affected by MS. The catchment area of the MS Center includes the Washington Heights area of northern Manhattan, mainly populated by low-income Hispanics and African-Americans. As a result, it has a very diverse patient population and in the past year, there were more than 2000 patient visits to the center. In addition, there were approximately 60 inpatient MS consultations.
MS is an extremely variable illness that seems to affect each individual differently. The MS Center has assembled a multidisciplinary team of health care providers with different areas of expertise in order to meet the specific needs of each and every patient. The team includes neurologists, a nurse practitioner and clinical research coordinator, a social worker, a psychiatrist, neuropsychologists, urologists, experts in pain management, and several of the world’s leading neuro-ophthalmologists. They work closely with an outstanding group of neuroradiologists and utilize state-of-the-art magnetic resonance imaging for diagnostic purposes, as well as to monitor disease progression and response to therapy. Patients involved in clinical research studies have access to advanced magnetic resonance imaging, including functional MRI, magnetization transfer, diffusion tensor, and spectroscopy at the world-class Hatch Magnetic Resonance Research Center, which is located just two floors below the MS Center. The Department of Rehabilitation Medicine provides comprehensive services to inpatients and outpatients with MS. Physiatrists, occupational and physical therapists, speech-language pathologists, therapeutic recreation specialists, rehabilitation nurses, and orthotist-prosthetists provide a variety of services, including rehabilitation, home modification evaluations, wheelchair and scooter evaluations, speech and swallowing evaluations, and augmentative communication assessments for patients in need of these services. Many patients who are treated with intravenous MS therapies receive their infusions at the MS Center. Patients with severe MS attacks that are unresponsive to steroids can receive plasma exchange on either an inpatient or outpatient basis.
Multiple sclerosis affects approximately 400,000 people in the United States and 2.5 million worldwide. Less than 20 years ago, MS was not considered a treatable neurologic illness. Fortunately, MS patient care has been has been revolutionized over the past 15 years. We now have a much better understanding of the immunopathogenesis of MS and there are currently seven U.S. Food and Drug Administration-approved therapies that alter the course of the disease. However, these therapies are only partially effective and most people with MS develop disability over time. Furthermore, the disease-modifying drugs have no effect on preexisting neurological deficits and symptoms. Common daily symptoms of MS include spasticity, weakness, depression, fatigue, sexual dysfunction, bowel and bladder dysfunction, pain, and cognitive dysfunction. In addition, MS often results in a significant financial and psychosocial burden on individuals affected by the disease as well as their family members and loved ones. Consequently, optimal management of MS patients requires a multidisciplinary approach involving various health care professionals. A nurse and a social worker are vital members of any MS multidisciplinary team and play essential roles in optimizing patient care, helping to reduce the physical and psychosocial burden of the disease, and improving quality of life.
This grant will support the salary of a nurse practitioner, which will allow the Center to continue to provide superior nursing care to its patients. He/she will provide routine patient care (e.g. blood draws, bladder catheterizations when necessary), help devise treatment plans to meet the individual needs of patients, optimize symptomatic therapy (e.g. treatment of bowel, bladder, and/or sexual dysfunction), train patients how to properly take their injectable MS medications, and provide extensive counseling and education to patients and their families. Other responsibilities include treating patients that require intravenous infusions with corticosteroids or Tysabri.
The Center is currently involved in numerous phase 2 and 3 immunomodulatory therapy clinical trials for both relapsing and progressive forms of MS. They are working on novel immunomodulatory agents and treatment strategies to alter the course of MS, as well as symptomatic therapies to improve functioning and quality of life in people affected by the disease. In addition to the aforementioned responsibilities, the nurse practitioner supported by this grant will also coordinate the clinical research program.
The grant also supports the work of Susan Morer, LMSW, C-ASWCM, a social worker who joined the MS Center staff in September of 2009. Ms. Morer obtained her Master of Science degree from Columbia University School of Social Work and was a social worker at the Southern New York Chapter of the National Multiple Sclerosis Society prior to joining the MS Center. Ms. Morer is an essential member of the team. She provides a variety of services to patients, ranging from individual and family counseling to the administration of health and welfare programs, such as facilitating the procurements of entitlement benefits. Ms. Morer is an advocate for patients and their rights to services and benefits. She creates and provides information and referrals to community resources and programs, develops support programs for patients and their families, and educates individuals with newly diagnosed and chronic MS.