Developing and auditing multiple sclerosis relapse management guidelines

Abstract

This article describes the development and audit of local guidelines on how to manage multiple sclerosis (MS) relapses based on the National Institute for Health and Clinical Excellence (NICE) guidelines (2003). This was a collaboration between MS specialist nurses and neurologists with a specialist interest in MS working in southeast London, Kent and Medway. The aim was to promote a consistent approach to the management of relapses that reflected best practice and prescribing guidelines as outlined in the NICE guidelines (2003). The audit revealed that patients benefited from the use of high-dose oral methylprednisolone steroids by offering them swift access to treatment that was generally well tolerated and cost effective. In the process of the evaluation other methods of relapse management were reviewed. Further evaluation of the use of high-dose oral methylprednisolone for MS relapses is required, with particular reference to its efficacy when compared to the more established treatment with intravenous methylprednisolone.