Providing optimal patient care in multiple sclerosis (MS) is dependent on both the patient and the healthcare system. One of the greatest challenges to optimal patient care is ensuring patient adherence to treatment. The two reasons given most often for treatment discontinuation are adverse effects and lack of efficacy. Adverse effects can be anticipated and managed, in part through well-established protocols, but also through industry-sponsored nursing support programs. These strategies can reduce needless discontinuations when patients experience common adverse effects. Lack of efficacy can be addressed for many patients by providing them with enough education to develop reasonable expectations for treatment and long-term prognosis. As important as early and continuous treatment are, these strategies are essential for providing optimal patient care in MS.