AUTHOR=Caparó-Zamalloa César , Velásquez-Rimachi Victor , Mori Nicanor , Dueñas-Pacheco Wenzel Ivan , Huerta-Rosario Andrely , Farroñay-García Chandel , Molina Roberto A. , Alva-Díaz Carlos 

TITLE=Clinical Pathway for the Diagnosis and Management of Patients With Relapsing–Remitting Multiple Sclerosis: A First Proposal for the Peruvian Population

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.667398

DOI=10.3389/fneur.2021.667398

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Relapsing–remitting multiple sclerosis (RRMS) is a subtype of degenerative inflammatory demyelinating disease of multifactorial origin that affects the central nervous system and leads to multifocal neurological impairment.</p><p><bold>Objectives:</bold> To develop a clinical pathway (CP) for the management of Peruvian patients with RRMS.</p><p><bold>Methods:</bold> First, we performed a literature review using Medline, Embase, Cochrane, ProQuest, and Science direct. Then, we structured the information as an ordered and logical series of five topics in a defined timeline: (1) How should MS be diagnosed? (2) How should a relapse be treated? (3) How should a DMT be initiated? (4) How should each DMT be used? and (5) How should the patients be followed?</p><p><bold>Results:</bold> The personnel involved in the care of patients with RRMS can use a series of flowcharts and diagrams that summarize the topics in paper or electronic format.</p><p><bold>Conclusions:</bold> We propose the first CP for RRMS in Peru that shows the essential steps for diagnosing, treating, and monitoring RRMS patients based on an evidence-based medicine method and local expert opinions. This CP will allow directing relevant clinical actions to strengthen the multidisciplinary management of RRMS in Peru.</p>