Supplements | A Data-Driven Approach to Improving Clinical and Economic Outcomes in Multiple Sclerosis [CME/CNE/CPE]

CME Information

Release date: November 20, 2013 |  Expiration date: November 20, 2014
Estimated time to complete activity: 2.5 hours
Type of Activity: Knowledge | Activity fee: Free of charge
Medium: Print with Internet-based posttest, evaluation, and request for credit.

This activity is supported by educational grants from Bayer HealthCare Pharmaceuticals; Biogen Idec; EMD Serono, Inc; Genzyme Corporation; and Questcor Pharmaceuticals, Inc.

Intended Audience
Physicians, nurses, medical directors, pharmacy directors, specialty pharmacists, and other managed care professionals who oversee the treatment of patients with multiple sclerosis.

Statement of Educational Need
Recent research into the complex pathophysiology of multiple sclerosis (MS) has yielded several key observations that underscore the need for improved diagnosis leading to early treatment. Disease progression has been shown to occur in the absence of clinical relapses, and even early relapses that appear relatively benign may have permanent neurological consequences. Key opinion leaders have concluded that MS is a neurodegenerative disease associated with a deregulated inflammatory cascade of life-changing symptomatology and cognitive dysfunction resulting in an economic burden that affects patients, providers, and society as a whole. Aggressive and early treatment with disease-modifying drug (DMDs), as recommended by the National MS Society, has begun to demonstrate positive long-term outcomes, a potential for reduced future disease activity, and improved patient quality of life.

Because the need for pharmacotherapy in MS patients is lifelong, sustaining adherence to therapy is critical to successful management. In a survey recently administered by the Pharmacy Times Office of Continuing Professional Education (PTOCPE), a significant proportion of clinician survey respondents indicated a lack of some degree of knowledge regarding the role of DMDs and supportive therapies in MS, underscoring the need for effective education on currently available DMDs and pharmacotherapies, improved working knowledge of the comparative efficacy and safety profiles of approved agents, increased familiarity with beneficial supportive therapies for patients, and a better understanding of best clinical practices and therapeutic strategies in MS as a whole.

A recent longitudinal study found that approximately 43% of patients with MS were not being treated with a DMD, and between 17% and 40% of those prescribed a DMD will discontinue treatment within 1 year of initiation. This highlights 2 major gaps in patient care: (1) the need to increase awareness of optimal pharmacotherapies that are available for patients, and (2) the need to improve clinician-driven strategies to drive patient medication adherence. While the appropriate management of MS is certainly complex and difficult, additional learning resources for clinicians will provide the information that ultimately drives optimal clinical outcomes through improved professional competence and performance.

This supplement to The American Journal of Managed Care is intended to provide current information regarding the epidemiology and pathophysiology of MS; the impact of the disease on patient health and quality of life; current treatment strategies; best clinical practices; and the economic burden MS places on patients, providers, and society as a whole. The discussion will feature an overview of MS; an overview of the mechanism of action, benefits, and risks of approved and emerging therapies; and a review of the cost burden associated with worsening disease.

Educational Objectives
Upon completion of the educational activity, the participant should be able to:
  • Examine the epidemiology, pathophysiology, spectrum of symptoms, and potential progression of MS, including MS disease classification and role of neuroimaging, to facilitate appropriate strategies in comprehensive disease management
  • Evaluate current and emerging therapeutic approaches with potential for disease modification in MS and their role in the total treatment paradigm
  • Evaluate the currently available DMDs and supportive care therapies to determine the appropriateness of individual therapies for the unique classifications of disease
  • Identify improved risk assessment and risk management strategies in the management of MS in the clinical setting and within the context of managed care
  • Explore innovative patient strategies to sustain medication adherence, to improve economic and clinical outcomes in MS

Physician Credit
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing
Medical Education (ACCME) through the joint sponsorship of The Consortium of Multiple Sclerosis Centers, Nurse Practitioner Alternatives, and Pharmacy Times Office of Continuing Professional Education. The Consortium of Multiple Sclerosis Centers is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
The Consortium of Multiple Sclerosis Centers designates this enduring material activity for a maximum of 2.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Credit
Accreditation Statement
Nurse Practitioner Alternatives is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This activity has been awarded 2.25 credits (1.25 of these credits are in the area of pharmacology).

Pharmacist Credit
Accreditation and Credit Designation
Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2.5 contact hours (.25 CEUs) under the ACPE universal activity number 0290-9999-13-162-H01-P. The activity is available for CE credit through November 20, 2014.
Obtaining Credit: Participants must read each article in this supplement, complete the online posttest achieving a passing score of 70% or higher, and complete an online evaluation and request for credit. Detailed instructions on obtaining CE credit are included following the sample online posttest.


Clyde E. Markowitz, MD
Director, Multiple Sclerosis Center
Chief, Multiple Sclerosis Division
Associate Professor of Neurology
Perelman School of Medicine
University of Pennsylvania
Philadelphia, Pennsylvania

Amy Perrin Ross, APN, MSN, CNRN, MSCN
Neuroscience Program Coordinator
Loyola University Chicago
Maywood, Illinois

Gary M. Owens, MD
Gary Owens Associates
Ocean View, Delaware

Contributing Editorial Support

Steve Lin, PharmD, RPh
Director of Scientific Affairs
Pharmacy Times Office of Continuing Professional Education

William Perlman, PhD, CMPP
Medical Director
Califon, New Jersey

Disclosure Policy
According to the disclosure policies of The Consortium of Multiple Sclerosis Centers, Nurse Practitioner Alternatives, and Pharmacy Times Office of Continuing Professional Education, all persons who are in a position to control content are required to disclose any relevant financial relationships with commercial interests. If a conflict is identified, it is the responsibility of The Consortium of Multiple Sclerosis Centers, Nurse Practitioner Alternatives, and Pharmacy Times Office of Continuing Professional Education to initiate a mechanism to resolve the conflict(s). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence. 

These faculty have disclosed the following relevant commercial financial relationships or affiliations in the past 12 months.

Clyde E. Markowitz, MD
Consultant or paid advisory board: Bayer HealthCare Pharmaceuticals; Biogen Idec; EMD Serono, Inc; Genentech; Genzyme Corporation; Novartis; Teva

Amy Perrin Ross, APN, MSN, CNRN, MSCN
Consultant or paid advisory board: Acorda Therapeutics; EMD Serono, Inc; Genzyme Corporation; Novartis; Teva
Lecture fees: Acorda Therapeutics; Biogen Idec; EMD Serono, Inc; Novartis; Pfizer, Inc; Teva

Gary M. Owens, MD
Consultant or paid advisory board: Biogen Idec; Genzyme Corporation; Novartis
Meeting/conference attendance: Biogen Idec; Genzyme Corporation

The American Journal of Managed Care
Publishing Staff—Jeff D. Prescott, PharmD, RPh, and Ida Delmendo have disclosed no relevant financial relationships with commercial interests.

Pharmacy Times Office of Continuing Professional Education
Planning staff—Judy V. Lum, MPA; David Heckard; Steve Lin, PharmD, RPh; Donna W. Fausak; and Ann C. Lichti, CCMEP, have disclosed no relevant financial relationships with commercial interests.

Nurse Practitioner Alternatives
Nurse planner—Laurie Scudder, DNP, NP, has disclosed no relevant financial relationships with commercial interests.

The Consortium of Multiple Sclerosis Centers
Planning staff—June Halper, ANP, FAAN, MSCN, has disclosed receipt of fees from Acorda Therapeutics for non-CE services.

All materials have been reviewed by an independent clinician who has disclosed no relevant financial relationships with commercial interests.

Off-label Disclosure and Disclaimer
The contents of this CME/CNE/CPE supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these
products in the United States. Physicians, nurses, and pharmacists should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

For additional information about approved uses, including approved indications, contraindications, and warnings, participants are advised to consult prescribing information for all products discussed. The information provided in this CME/CNE/CPE activity is for continuing medical and pharmacy education purposes only and is not meant to substitute for the independent medical or pharmacy judgment of a physician, nurse, or pharmacist relative to diagnostic, treatment, or management options for a specific patient’s medical condition.

The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of The American Journal of Managed Care, The Consortium of Multiple Sclerosis Centers, Nurse Practitioner Alternatives, Pharmacy Times Office of Continuing Professional Education, or any of the companies that provided commercial support for this CME/CNE/CPE activity.

Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.

Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, the editorial staff, or any member of the editorial advisory board. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, is not responsible for accuracy of dosages given in articles printed herein. The appearance of advertisements in this publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements.

Publisher’s Note: The opinions expressed in this supplement are those of the authors, presenters, and/or panelists and are not attributable to the sponsor or the publisher, editor, or editorial board of The American Journal of Managed Care. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this supplement are not necessarily the same as indicated in the package insert for the product and may reflect the clinical experience of the authors, presenters, and/or panelists or may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.

System Requirements
PC-based participants
Windows 7, Vista, XP, 2003 Server, or 2000

Macintosh®-based participants
Required: Mac OS X 10.4.11 (Tiger) or newer

© 2013 Managed Care & Healthcare Communications, LLC




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