March 18, 2021 astruble

Family Planning With Multiple Sclerosis

March is Multiple Sclerosis (MS) Awareness Month and Shields is proud to support over 5000 patients across 20 of our partner health-systems with their MS treatment. According to the National MS Society, the disease affects roughly one million people in the United States. Therefore, it is important to us at Shields to show our support and do our part to drive better outcomes for our partners’ patients.

We want to share a story that reflects the commitment our pharmacy team shows every day in providing the support and care necessary to keep their MS patients healthy. Shields Director of Clinical Services, Kate Smullen, and Regional Clinical Pharmacist, Carolkim Huynh, worked with a newly diagnosed male MS patient to educated him on how he could safely family plan in parallel to starting his MS treatment journey.

Starting a family is an exciting stage in one's life, but it can also be scary for patients battling chronic illnesses such as MS, where treatments could have harmful side effects. In cases where patients are taking a form of immunosuppressant, pregnancy must be planned, and the treatment must be modified, as necessary. MS patients have a limited pool of disease-modifying agents.

Recently we reached out to this newly diagnosed male MS patient to educate him on starting new MS medication and get more information about any potential risks that may interfere with family planning. The pharmacist actively listened to his concerns and further researched what information was available to help him make this decision. He stated that he and his wife were hoping to start their family but feared his new MS medication' would potentially cause harmful effects that could be passed on or increase infertility. This patient also wanted to understand his options knowing MS was limited in selecting oral therapy vs. traditional injectables. Like many patients, his preference was to use an "oral medication" but wanted to be sure that this was the best decision promoting safety and achieving his goal of starting a family.

Our pharmacist let this patient know that his concerns were valid, and they would be happy to do some research uncovering what is available and recommended. Research on effects with pregnancy is often limited as this group is excluded from most clinical trials; even more rare are studies on male infertility. Therefore, we often rely on published case studies, adverse event reporting, or data collected from registries to gain further insight.

During the team's research, they collaborated with medical professionals at the National MS Society for further resources utilizing their database to cross-check available resources thoroughly. Knowing that this patient preferred oral medications, the Clinical team focused efforts on finding any information specific to male infertility and safety during the time of conception.

Through the team’s research and working with the National MS Society, they were able to better understand the options this patient had to educate, support, and assist him in making a choice knowing all of the risks, benefits to weigh out available options. The team provided extremely helpful information on oral options that no one else prior had supported with evidence, where he felt his concern was overlooked.

While the information around male infertility for MS medications was a rare topic and less studied, the team felt that had enough context within medical literature to help the patient make an informed decision, including him in the process.

The patient was extremely relieved to have access to the correct information and felt that a weight had been lifted off his shoulders, knowing that he could begin MS medication and start a family with his wife. The patient stated that he had been to two different specialists with his diagnosis and felt confused after receiving two different answers. When Carolkim provided him with validated clinical context, he felt much more informed.

By actively listening to the patient and helping him find the information he needed instead of giving him the standardized response of, “I’m sorry nothing is studied ask your doctor,” the team was able to prevent a patient from delaying their MS treatment while adding comfort in knowing the risks to start his family. Like the hundreds of others our teams share every day, this story shows how impactful the Shields care model can be for a patient.

The Shields care model was instrumental in helping this patient get the information he needed to make a decision on not only his health but the health of his wife and potential family. Learn more about the outcomes our Shields care model provides MS patients below.

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