@article{783594b680a046af9ecdb6628ee1b87b,
title = "Constructing an adaptive care model for the management of disease-related symptoms throughout the course of multiple sclerosis - Performance improvement CME",
abstract = "Background: Symptom management remains a challenging clinical aspect of MS. Objective: To design a performance improvement continuing medical education (PI CME) activity for better clinical management of multiple sclerosis (MS)-related depression, fatigue, mobility impairment/falls, and spasticity. Methods: Ten volunteer MS centers participated in a three-stage PI CME model: A) baseline assessment; B) practice improvement CME intervention; C) reassessment. Expert faculty developed performance measures and activity intervention tools. Designated MS center champions reviewed patient charts and entered data into an online database. Stage C data were collected eight weeks after implementation of the intervention and compared with Stage A baseline data to measure change in performance. Results: Aggregate data from the 10 participating MS centers (405 patient charts) revealed performance improvements in the assessment of all four MS-related symptoms. Statistically significant improvements were found in the documented assessment of mobility impairment/falls (p=0.003) and spasticity (p<0.001). For documentation of care plans, statistically significant improvements were reported for fatigue (p=0.007) and mobility impairment/falls (p=0.040); non-significant changes were noted for depression and spasticity. Conclusions: Our PI CME interventions demonstrated performance improvement in the management of MS-related symptoms. This PI CME model (available at www.achlpicme.org/ms/toolkit) offers a new perspective on enhancing symptom management in patients with MS.",
keywords = "Depression, fatigue, mobility, performance improvement, spasticity, symptom management",
author = "Miller, \{Aaron E.\} and Cohen, \{Bruce A.\} and Krieger, \{Stephen C.\} and Markowitz, \{Clyde E.\} and Mattson, \{David H.\} and Tselentis, \{Helen N.\}",
note = "Funding Information: BAC has served as a consultant for Acorda, Astellas, Biogen Idec, EMD-Serono, Genzyme, Sanofi-Aventis, and Teva Neuroscience and has received research support though Northwestern University from Biogen Idec, Hoffman La Roche, and Novartis. SCK has received grant support from Bayer HealthCare Pharmaceuticals and consulting fees from work with Acorda Therapeutics, Bayer HealthCare Pharmaceuticals, Biogen Idec, EMD Serono, Genzyme, Novartis, Questcor, and Teva Neuroscience. CEM has received grants and research support from Bayer, Biogen Idec, EMD Serono, Novartis, Ono Pharmaceutical Group, and Teva; he has also served as a consultant for Acorda, Bayer, Biogen Idec, EMD Serono, Novartis, and Sanofi-Aventis. DHM has received research contracts and honoraria for speaking and consulting from Teva Neuroscience, Biogen Idec, and Novartis; research contracts and honoraria for speaking from Acorda Therapeutics and Genzyme; honoraria for speaking from EMD-Serono, Bayer, and Pfizer; and research contracts from MedImmune, Roche, ONO, Genentech, Sanofi-Aventis, Actelion, and Vaccinex. In the last year, AEM has received research support from Acorda, Biogen Idec, Genentech, Genzyme, Novartis, Osmotica, Questcor, Roche, and Sanofi-Aventis and has served as a consultant for Acorda, Biogen Idec, EMD Serono (Merck Serono), GlaxoSmithKline, Novartis, Nuron Biotech, Ono Pharmaceutical Group, Sanofi-Aventis, and Teva. HNT declares she was formerly employed by The Academy for Continued Healthcare Learning, which received unrestricted educational grants from Acorda Therapeutics. Funding Information: This work was supported by Acorda Therapeutics, Inc. (unrestricted educational grant number: Acorda Grant ID number: 495937 CS2011CA38). Funding Information: Although the recognition and treatment of symptoms in patients with MS present special challenges, a systematic effort in care may result in positive outcomes. A performance improvement continuing medical education (PI CME) activity was designed to enhance the management of disease-related symptoms in persons with MS through the joint sponsorship of Purdue University College of Pharmacy, PeerView Institute for Medical Education (PVI), and The Academy for Continued Healthcare Learning (ACHL; an accredited medical education provider). The PI CME activity was funded by an educational grant provided by Acorda Therapeutics, Inc. ",
year = "2014",
month = jan,
doi = "10.1177/1352458513495937",
language = "English",
volume = "20",
pages = "18--23",
journal = "Multiple Sclerosis Journal",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",
number = "1",
}