The management of multiple sclerosis is complex due to clinical heterogeneity, advancements in therapeutics, and influence of co-morbidities on outcomes. Furthermore, concomitant vascular risk factors and adverse health behaviors (e.g. smoking) which have been shown to be associated with worse clinical outcomes in patients with MS may not be adequately controlled due to lack of access to care. To provide comprehensive care to people with MS while improving access to care, a pharmacist-run MS Optimization Clinic was developed.

The Multiple Sclerosis Optimization Clinic is a referral based collaborative model developed to offer medication management of DMTs as well as vascular risk factor management to patients with multiple sclerosis within a neurology ambulatory clinic setting.  A signed collaborative practice agreement between a dedicated clinical pharmacist faculty member and an MS fellowship trained neurologist was established to enable the clinical pharmacist to order laboratory tests and adjust medications. During the MS Optimization Clinic visit, emphasis is placed on obtaining an accurate medication history; assessing for barriers and counseling on the importance of adherence; monitoring for adherence, adverse effects, tolerability, safety and effectiveness of therapy; and counseling on the importance of smoking cessation and life style modifications on MS outcomes.

A multidisciplinary collaborative care model that provides an infrastructure for targeted management of DMT as well as disease state management of vascular co-morbidities can potentially optimize outcomes for patients with multiple sclerosis.