Brain disorders can be highly disabling and they are also remarkably common, affecting one in three European citizens during their lifetime.1 The big question for policy makers trying to minimize disability from brain disorders is where to focus their limited resources.
The Value of Treatment for Brain Disorders policy white paper was launched by the European Brain Council (EBC) in Brussels on Thursday 22 June 2017.2 It makes policy recommendations based on in-depth case studies in nine disease areas: schizophrenia, Alzheimer’s disease, epilepsy, headache, multiple sclerosis, normal pressure hydrocephalus, Parkinson’s disease, restless leg syndrome and stroke.
Professor David Nutt, President of the EBC, introduced the document and highlighted examples of best practice which demonstrate that interventions can be cost-effective and lead to better outcomes.
Speakers representing a cross-section of disease areas highlighted the importance of:
This policy white paper represents the culmination of a 2-year collaborative research project by the EBC, and brings us a step closer to improving the standards of care for people with brain disorders across Europe.
1. Wittchen HU, Jacobi F, Rehm J et al. The size and burden of mental disorders and other disorders of the brain in Europe. Eur Neuropsychopharmacol 2011;21:655–79. doi: 10.1016/j.euroneuro.2011.07.018.
2. European Brain Council. The Value of Treatment for Brain Disorders, June 2017. Available from: http://www.braincouncil.eu/wp-content/uploads/2017/06/EBC-VoT-White-Policy-Paper.pdf (Accessed 3 July 2017).
The impact of early diagnosis, effective treatment and a brain-healthy lifestyle was highlighted throughout the 2016 Annual Conference of the European Multiple Sclerosis Platform (EMSP) in Oslo this week.
Speaking on the opening day of the conference, Professor Eva Havrdová (Charles University, Prague) made the case as to why time matters when treatment is started. “If we are losing time, we are losing brain.”
According to health economist Dr Gisela Kobelt (European Health Economics), the time to diagnosis is shorter than it was 10 years ago, but is still too long. “A delay of 3–4 years is too long to diagnosis. You need to preserve the brain reserve.”
The comments support key recommendations in the policy report Brain health: time matters in multiple sclerosis, launched in October 2015. Its core recommendation is that the goal of treating MS should be to preserve tissue in the central nervous system and maximize lifelong brain health by reducing disease activity.
The importance of early intervention in MS with the most appropriate agents was discussed more fully during a parallel session chaired by Norwegian neurologist Professor Øivind Torkildsen. Contributions from MSer George Pepper (Shift.ms), Professor Havrdová and EMSP’s Christoph Thalheim were also well received. Attendees at the session offered feedback on Brain health: a guide for people with multiple sclerosis, a short summary of the policy report written especially for people with MS.
The MS Society of Norway became the latest endorser of the policy report, bringing the total number of endorsers to date to 26. The MS Brain Health team is continuing to seek endorsement from local and regional groups, as well as identifying ‘brain health champions’ among healthcare professionals, advocates and people with MS.
More people will start to die from surgical procedures and cancer treatments unless urgent global action is taken to tackle antimicrobial resistance.
The call follows the publication of a new study in The Lancet that has investigated the potential consequences of increases in antibiotic resistance on the 10 most common surgical procedures and immunosuppressing cancer chemotherapies in the USA that rely on antibiotic prophylaxis.1
The findings estimate that up to half of infections after surgery and over a quarter of infections after chemotherapy in the USA are caused by organisms resistant to standard antibiotics. The study predicts that if antibiotics become 30% less effective in the USA, it could lead to 120 000 more infections in patients undergoing surgery or chemotherapy, and 6300 infection-related deaths each year.
“It really does show how urgent the situation is, how we now need global action if we are not to approach a post-antibiotic era where common infections will be untreatable,” said Dr Liz Tayler (of the World Health Organization’s Antimicrobial Resistance Secretariat) on BBC Radio 4’s Today programme.
Concern continues to grow worldwide. President Obama launched a 5-year plan earlier this year to fight the threat posed by antibiotic-resistant bacteria.2 In the UK, the Review on Antimicrobial Resistance, commissioned by Prime Minister David Cameron, is due to present its final report with recommendations for global solutions in spring 2016.3
1. Teillant A et al. Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: a literature review and modelling study. Lancet Infect Dis 2015;doi:10.1016/S1473-3099(15)00270-4
2. National action plan for combating antibiotic-resistant bacteria (NAP). Available from: https://www.whitehouse.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf
3. Review on Antimicrobial Resistance. Available from: http://amr-review.org/home
“Treat MS properly at the start and we may be able to delay or prevent the secondary progressive phase.”
The outlook for people with multiple sclerosis (MS) looks likely to improve. That was the message from Professor Gavin Giovannoni as he addressed over 400 delegates at the MS Trust Conference in Windsor, UK. In his talk, ‘Looking to the future’, Professor Giovannoni summarized clinical trial results for products at different stages of development and presented the therapeutic strategy outlined in Brain health: time matters in multiple sclerosis.
Highlighting the importance of early diagnosis and treatment initiation, Professor Giovannoni proposed a future where we “stop people with MS becoming disabled in the first place”. He told fellow healthcare professionals: “treat MS properly at the start and we may be able to delay or prevent the secondary progressive phase”. Professor Giovannoni also emphasized the need for a clear treatment goal, regular monitoring of patients using MRI and timely switching of therapies when disease control is suboptimal to preserve brain health.
Delegates included MS specialist nurses, physiotherapists and researchers, and every delegate received a four-page summary of the policy recommendations. Professor Giovannoni urged the audience, and anyone who wants to improve the lives of people with MS, to pledge their support to protect brain health at www.msbrainhealth.org/pledge.
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A therapeutic strategy in multiple sclerosis (MS) involving proactive monitoring, shared decision-making and improved treatment access needs to be widely accepted – and urgently adopted.
This important message could reach up to 9000 specialists at ECTRIMS, the largest MS conference in the world, when it is presented by lead author Gavin Giovannoni this afternoon. His late-breaking poster summarizes the recommendations from a new report, Brain health: time matters in multiple sclerosis, which was launched on 6 October 2015 by Oxford Health Policy Forum as the centrepiece of the MS Brain Health initiative.
“Everything in the recommendations is driven by delays in the system of our management of multiple sclerosis,” stated Professor Giovannoni at the report launch. “What can we do to optimize or maximize the brain health of somebody who presents to healthcare professionals with MS?”
The poster concludes that the recommendations will enable healthcare professionals to strive towards the highest possible standards of care, but that major policy changes are needed for this to become a reality.
Time matters in multiple sclerosis – international consensus recommendations on diagnosis, management and access to treatment, will be available to download from the MS Brain Health initiative website after the start of the poster session at 13:30 GMT on Friday 9 October.
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