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CME: Therapeutic Updates, Best Practices and Barriers to Care in the Prevention and Treatment of Multiple Sclerosis

Activity Description / Statement of Need:

In this online CME self-learning program:


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.  One study suggests that one out of two patients with MS who discontinue taking their immunomodulatory medication does so within the first two years of therapy, and that those with higher degrees of disability are particularly at risk.





Introduction, Disclosures

Epidemiology and risk factors for MS

•Statistics: snapshots and trends

•Neurological dysfunction due to inflammatory and degeneration of the central nervous system

•Genetic, viral, and environmental influences

•Controversy: chronic cerebral spinal insufficiency

Symptomology and diagnosis of MS

•Neurologic symptoms or signs suggestive of demyelination

•Confirmation of lesions: MRI and evoked potential studies

•International diagnostic criteria for MS

•Differential diagnosis (rule out: atypical MS, Devic’s disease)

•Lab tests, biopsy, and pathology

•Different types (relapsing-remitting, secondary progressive, primary progressive, progressing-relapsing, malignant, fulminant)

•Patient cases

Treatment of patient with MS

•Clinically isolated syndrome

•Acute exacerbations

•Disease-modifying therapies for relapsing MS

•Primary progressive MS

•Symptom-case treatment

•Physical therapy

•Diet modification and life style intervention

•Best practice: putting it all together

•Patient cases

Barrier to Optimal Care in Patients with Multiple sclerosis


•Expense of therapy

•Difficulty accepting incurable nature of disease (only symptomatic management presently available)

•Patient confusion around different routes and schedules associated with the different components of combination therapy

•Patient cases

Summary, conclusion, and best practice recap

Target Audience:

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

This program is supported by an educational grant from EMD Serono.

Release Date: May 12, 2013 -- Expiration Date: May 12, 2015

Faculty: Jacquelyn Bainbridge, PharmD, FCCP -- Caleb Oh, PharmD


Learning Objectives

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

  • Describe symptoms, epidemiology, comorbidities, costs, reimbursement, and managed care-related challenges impacting patients with MS
  • Describe the challenges associated with diagnosis of MS.
  • Describe the challenges associated with treating patients with MS.
  • Apply existing diagnostic recommendations and criteria to practice in the management of MS.
  • Identify the treatment modalities currently available for management of MS* and apply them to patient cases using evidence-based medicine.



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: Jacquelyn Bainbridge, PharmD has received honoraria from TEVA and UCB Pharma and has received research funding from NIH.


Faculty Disclosure: Caleb Oh, PharmD has received research funding from NIH.


Disclosures of Educational Planners: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC with no relevent financial disclosures.


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


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge 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.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

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.