MS management is usually multi-faceted:

1. Treatment of relapses

The first strand of management, treating relapses usually involves the use of steroids. Steroids can cause lots of side effects, from weight gain and hunger to osteoporosis and diabetes, so are usually used for a very short time only.

2. Symptom management

Symptom management involves tackling problems on an individual basis to try and make them tolerable and improve quality of life. For example, someone who is experiencing mobility issues may undertake an exercise programme under the supervision of a physiotherapist; take medication prescribed by a GP for dizziness or tremor; and be under an occupational therapist for assessment for mobility aids, such as a walking stick, and home adaptations, such as grab rails and a stair lift, in order to retain as much independence as possible.

3. Disease modifying therapies

Disease modifying therapies are used to try and reduce the frequency and severity of relapses, by limiting the demyelination process. A number of different drugs are used for this purpose, including glatiramer, beta interferon and drugs ending in the suffix -zumabs, and there are strict criteria around who is eligible to try them.

Multidisciplinary support

Much like PD, patients with MS should be under the care of a specialist doctor and a multidisciplinary team in order that they can access people with the right expertise when they need to. Close monitoring is necessary, at the very least a comprehensive annual review of the patient and their condition should be undertaken, during which current and possible future treatments, symptoms and support should be discussed.

Pharmacy staff can be an important part of the care and support team for someone with MS, advising on stopping smoking, as research has shown that this can help slow disease progression; healthy eating; and exercise, as well as other ways to stay well such as taking advantage of any vaccinations on offer.

The emotional side of having a progressive long-term condition for both the patient and their close family and friends should not be overlooked, so offering a sympathetic ear and knowing where to go for more help and information, such as local support groups, is crucial.

Practice point

• Have a look at a steroid treatment card to remind yourself of the advice you should give someone who is on them for longer than three weeks.