Multiple sclerosis in adults: management

Multiple sclerosis in adults: management [NG186]
NICE updated November 2019
This guideline covers diagnosing and managing multiple sclerosis in people aged 18 and over. It aims to improve the quality of life for adults with multiple sclerosis by promoting symptom management, comprehensive reviews and effective relapse treatment.
Updates relate to use of Sativex (a THC:CBD spray) and gabapentin

Rehabilitation for people with multiple sclerosis

Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews
Cochrane Systematic Review 14 January 2019

• Review of 15 Cochrane reviews (168 clinical trials) showed some benefits for people with MS who participated in exercise and physical activity programmes or multidisciplinary rehabilitation programmes (where the intervention is provided by a team of health professionals from different professions). They found improvements in everyday activities, function, and health‐related quality of life, compared with those who were not offered rehabilitation. 
• Evidence for other rehabilitation modalities was limited, due to lack of good‐quality studies. 

Non‐pharmacological interventions for chronic pain in multiple sclerosis

Non‐pharmacological interventions for chronic pain in multiple sclerosis: systematic review
Cochrane Library 19 December 2018

• Reviewers found 10 studies (n=565) evaluating different non‐medication treatments to treat chronic pain in persons with Multiple Scloerosis (MS). The treatments evaluated included: transcutaneous electrical nerve stimulation, transcranial direct stimulation, transcranial random noise stimulation, reflexology, psychotherapy and hydrotherapy. 
• Results from these studies show a very low level of evidence for the use of any non‐medication treatments for chronic pain in persons with MS.

Improving care for people with MS: the potential of data and technology

Improving care for people with MS: the potential of data and technology
Nuffield Trust 10 July 2018

• An MS Society-commissioned report mapping out what technology is already available for people with MS, what more could be done with what is available and how data and technology could be better exploited in future to improve MS health care.
• The report examines four key areas in the lives and care of people with MS where the potential of data and technology could be harnessed to make a significant difference:
• Helping people with MS take more control of their care
• Accessible and coordinated care
• Improving access to the right treatments at the right time
• Using data to better meet patient needs