Other health behaviors may contribute not only to overall health, but also to the disease course. Patients who smoke have accelerated progression of their MS disease process and greater mortality than that of nonsmokers. 14 Likewise, patients who engage in regular physical activity experience not only greater strength and endurance, but also less fatigue, depression, and better QOL. 15 As part of his chronic illness care, the MS team provided William with information about the potential impact of health behaviors on MS progression.
William’s emotional and cognitive symptoms of MS presented important challenges to the management of his MS care. Initially, he ignored his diagnosis, delayed care, and refused to take a DMT. Once he agreed to taking a DMT, he often forgot to take it. He frequently missed medical appointments, because he did not remember them. Depression, fatigue, and stress decreased his motivation to follow through with recommendations from his health care providers.
Given William’s multiple psychosocial needs and transportation challenges, VA psychologists initiated telehealth visits with William in addition to clinic visits to provide many services, including psychotherapy and health behavior counseling. This continued support, along with the coordination of the rest of his health care team has been vital to maintaining William’s adherence to his treatment plan and QOL.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.