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CME: Multiple Sclerosis in a Primary Care Setting: Employing Strategies for Appropriate Diagnosis and Improved Patient Outcomes


Activity Description / Statement of Need:

In this online, self-learning activity:

During the first five years of immunomodulatory therapy, one to two out of every five patients with multiple sclerosis MS stops taking their prescribed therapy. Evidence shows that one of the major determinants of how well a patient with MS adheres to therapy is the relationship the patient has with his or her healthcare provider; the degree to which a patient feels support from his or her provider is actually an independent predictor of adherence, according to a survey of patients with self-reported progressive forms of MS. The establishment of trust is dependent on the extent to which the patient feels the provider is being honest and open about prognosis, diagnosis, and treatment options. Additionally, examinations of adherence to medical therapy in general highlight the necessity of a patient’s understanding of their clinical circumstances, goals of therapy, and complexity of their medical regimen, necessitating a provider’s comprehension of the same.  Logistical factors at play in the medical system, like high drug costs and difficulty in physically obtaining medications, also deter patients from optimal compliance with prescribed therapy. One other independent predictor of adherence to therapy is severity of disability. 

Target Audience:

Healthcare professionals specializing in: family medicine, geriatrics, internal medicine, primary care, or those who otherwise commonly care for patients with MS in the primary care setting.

This program is supported by an educational grant from Biogen.

This activity is free of charge.

Release Date: March 11, 2019 -- Expiration Date: March 11, 2021

Faculty: Christopher Lock, MD


Introductory and diagnostic content

  • Epidemiology: statistics by severity
  • Clinical features, presentation, pathophysiology, disease progression, and comorbidities 
  • Diagnostic criteria
  • Types
  • Clinically isolated syndrome
  • Relapsing-remitting
  • Secondary progressive
  • Primary progressive
  • Disease severity and its impact on relapses and mortality
  • Other prognostic factors
  • Patient case(s)

Treatment of MS

  • Dimensions in treatment
  • Acute attacks / exacerbations
  • Underlying disease
  • Chronic symptoms
  • Fatigue
  • Impaired gait
  • Spasticity
  • Pain
  • Bladder dysfunction
  • Bowel dysfunction
  • Mood disorders
  • Cognitive impairment
  • Sexual dysfunction
  • Ataxia and tremor
  • Minimizing adverse effects
  • Emerging and future therapies
  • Clinical trial findings and guideline updates
  • Specific comorbidities and symptoms
  • Other clinical pearls
  • Optimizing patients’ adherence to their therapy: benefits and barriers
  • Patient case(s)

Learning Objectives

By the end of the session the participant will be able to:

  • Summarize the pathophysiology, symptomology, and clinical course of MS
  • Formulate strategies to encourage patients to discuss MS impact on their activities of daily living in a sensitive manner to identify problems that may be treated
  • Given a patient case, select appropriate treatment options for managing acute exacerbations of MS
  • Given a patient case, select appropriate treatment options for managing chronic symptoms associated with MS
  • Explain effective approaches to promoting patient adherence, managing adverse effects of therapy, and addressing other barriers to care


ACCME Activity #201220070


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure: Christopher Bruce Lock, MD, PhD, Clinical Associate Professor Multiple Sclerosis and Neuroimmunology Program Stanford Neuroscience Health Center, is a consultant and/or on the speakers bureau  of Biogen, Sanofi Genzyme, EMD Serano, Interx, and Diagnose Early.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP has no relevant financial disclosures.

Commercial Support Disclosure: This program is supported by an educational grant from Biogen.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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