Constructing an adaptive care model for the management of disease-related symptoms throughout the course of multiple sclerosis - Performance improvement CME

Aaron E. Miller, Bruce A. Cohen, Stephen C. Krieger, Clyde E. Markowitz, David H. Mattson, Helen N. Tselentis

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)18-23
Number of pages6
JournalMultiple Sclerosis
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Depression
  • fatigue
  • mobility
  • performance improvement
  • spasticity
  • symptom management

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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