Casemanagement for people with Multiple Sclerosis.

Problems of the chronically ill are often extensive and complex. Healtcare delivery often fragmentated and differentiated. Casemanagement seems to be an organisational solution to this problems.

In this study casemanagement for people with MS is brought into practice. To examine the efftect of casemanagement on the quality of life, the quality of care and the healtcare costs an RCT is conducted in which the casemanagement is compared with the care as usual. because of the impact of living with a patner with an chronic disease the central informal caregiver is also part of the investigation.

People with Multiple Sclerosis who recieve care bij a casemanager experience a better quality of live and quality of care
compared with people with MS who receive care as usual.

Caregivers of people with Multiple Sclerosis who recieve care bij a casemanager experience a better quality of live
compared with caregivers of people with MS who receive care as usual.

healthcare cost for people with MS will increase during the first year in which they receive casemanagement. On the long term costs will decrease.

Casemanagement consist of homevisits twice a year by an Nurse practitioner or Nurse specialist MS. During the homevisit the neurological examination is performed and the health status (physically, mentally and socially) of the person with MS is investigated as well as the impact of the disease on the lifes of the person with MS and his/her caregiver.

Based on this investigation a care plan will be develloped. Realisation of the goals set in the care plan is monitored bij the casemanager.

In the control group the people with MS receive the care as usual. They will visit their Neurologist at the outpatient clinic once or twice a year (or more if indicated).
Both groupd consist of 50 persons with MS and 30 caregivers. The intervention will take place during 15 months.