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

ACCREDITATION EXPIRED: January 03, 2016

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, putting those patients at a higher risk of worsening symptoms.  The study’s authors call for “close follow-up of these patients would be useful in avoiding early discontinuation of therapy,” and primary care physicians, who are in a good place to communicate with patients about the barriers they face, may benefit from continuing education programming focusing on these challenges.

 

Moreover, clinical trial evidence and professional guidelines change, and some guidelines have been updated recently.  Communicating related information to healthcare professionals in a timely manner is a demonstrated need.  The literature suggests that practicing healthcare professionals are oftentimes unable to keep up with the steady publishing of literature and evolution of clinical practice, and awareness of professional guidelines is no exception.  Recently published guidelines therefore also inherently suggest a gap in medical knowledge, if not practice, and also justify the need for educational programming.

 

 

Agenda

 

Introduction, Disclosures

Epidemiology

Etiology

Diagnostic criteria

• -2010 McDonald Criteria

Types

• -Relapsing-remitting
• -Secondary-progressive
• -Primary-progressive
• -Progressive-relapsing

Dimensions in treatment

• -Acute attacks / exacerbations
• -Underlying disease
• -Chronic symptoms

Patient case

-Symptom management: coordinated care

• -Pharmacologic
• -Nonpharmacologic
• -Surgical
• -Patient education
• -The ‘ICAP’ method
• -Symptom list and corresponding prevalence

Patient case, continued

Specific symptoms and their management

• -Fatigue
• -Impaired gait
• -Spasticity
• -Pain
• -Bladder dysfunction
• -Bowel dysfunction
• -Mood disorders
  • --Pseudobulbar affect
• -Cognitive impairment
• -Sexual dysfunction
• -Ataxia and tremor
• -Summary and best practice

Adherence and persistence

• -Prevalence
• -Benefits
• -Barriers
• -Strategies

Costs

Case

Summary

Target Audience:

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

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This program is supported by an educational grant from Questcor.

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Release Date: January 03, 2014 -- Expiration Date: January 03, 2016

Faculty: Douglas R. Allington, Pharm.D., BCPS -- Michael P. Rivey, M.S., BCPS, FASHP

Agenda

Learning Objectives

Accreditation

Faculty Disclosure and Resolution of COI

Instructions

System Requirements