• Aaron E Miller, Bruce A Cohen, Stephen C Krieger, Clyde E Markowitz, David H Mattson, and Helen N Tselentis.
• Corinne Goldsmith Dickinson Center for MS and Icahn School of Medicine at Mount Sinai, New York, USA.
• Mult. Scler. 2014 Jan 1;20(1):18-23.

BackgroundSymptom management remains a challenging clinical aspect of MS.ObjectiveTo 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.MethodsTen 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.ResultsAggregate 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.ConclusionsOur 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.

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