Comorbidity is an area of increasing interest in MS and evidence has suggested comorbidity is associated with diagnostic delays, misinterpretation of relapses, disability progression, health-related quality of life, and progression of lesion burden on magnetic resonance imaging (MRI). In chronic diseases, it has been shown that comorbidities can affect multiple aspects of treatment.
The aim of this resource guide is to help clinicians recognize and differentiate comorbidities from MS symptoms, understand the impact of comorbidities on individuals, make decisions about treatment in the setting of comorbidities, and manage comorbidities in collaboration with other health care professionals. The general prevalence and impact of comorbidities in MS will be reviewed, with the greatest focus on psychiatric, vascular/metabolic, and autoimmune comorbidities. Conditions defined as comorbidities in this document are those that are chronic in nature and that originate by a mechanism that is distinct from the underlying MS.
The guide also includes a list of resources and useful websites.
Commercial Support Acknowledgement
This activity is supported by an educational grant from Sanofi Genzyme.
Release date: February 15, 2018
Valid through: February 15, 2019
Estimated Time to Complete Activity: 1.5 hours
This activity is intended for neurologists, nursing professionals, PAs, rehabilitation professionals, mental health specialists, case workers and other clinicians involved in the management of patients with MS.
Upon completing this activity, the participant should be better able to:
- List comorbidities commonly occurring in patients with MS
- Review the impact of comorbidities on initiating disease modifying therapy (DMT) for MS patients
- Identify symptoms of common comorbidities that may mimic symptoms of MS or MS relapse
- Apply strategies to diagnose comorbidities in MS patients
- Employ best practices for involving other members of the health care team or referrals if appropriate when managing comorbidities
- Review optimal treatment approaches to comorbidities in MS patients
- Employ best practices to engage patients in shared decision making regarding the management of their comorbidities and MS care
Ruth Ann Marrie, MD, PhD, FRCPC
Professor of Medicine & Community Health Sciences
Director Multiple Sclerosis Clinic
Max Rady College of Medicine, Rady Faculty of Health Sciences
University of Manitoba
Accreditation Statements and Credit Designations
In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC), Nurse Practitioner Alternatives (NPA), and Catamount Medical Education. CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The CMSC designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurse Practitioner Alternatives (NPA) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
NPA designates this enduring material for a maximum of 1.5 Continuing Nursing Education Credits (0.5 in the area of pharmacology).
Laurie Scudder, DNP, NP, has served as Nurse Planner for this activity. She has declared no relevant financial relationships.
All other healthcare professionals completing this course will be issued a statement of participation.
In accordance with the ACCME Standards for Commercial Support, the Consortium of Multiple Sclerosis Centers (CMSC), Nurse Practitioner Alternatives (NPA), and Catamount Medical Education require that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. CMSC, NPA, and Catamount Medical Education resolve all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all their educational programs. Furthermore, CMSC, NPA, and Catamount Medical Education seek to verify that all scientific research referred to, reported, or used in a CME/CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. CMSC, NPA, and Catamount Medical Education are committed to providing learners with high-quality CME/CE activities that promote improvements in health care and not those of a commercial interest.
Ruth Ann Marrie, MD, PhD, FRCPC Program Chair has declared no relevant financial relationships
Activity Staff Disclosures
- The planners, reviewers, editors, staff, or other members at CMSC who control content have declared that they have no relevant financial relationships.
- Laurie Scudder, DNP, NP, has served as Nurse Planner for this activity. She has declared that she has no relevant financial relationships.
- The planners, reviewers, editors, staff, CME committee, or other members at Catamount Medical Education who control content have declared that they have no relevant financial relationships.
Method of Participation / How to Receive Credit
There are no fees for participating in and receiving credit for this activity. During the period February 15, 2018 through February 15, 2019, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and activity evaluation online at www.MSComorbidities.com.
A score of at least 66.67% (4 out of 6 correct) on the post-test is required to successfully complete this activity. The participant may take the test until successfully passed. Complete the CME/CE evaluation/attestation form, which provides each participant with the opportunity to comment on how participating in the activity will affect their professional practice; the quality of the instructional process; the perception of enhanced professional effectiveness; the perception of commercial bias; and his/her views on future educational needs.
Credit documentation/reporting: If you are requesting AMA PRA Category 1 Credit(s)™, nursing credit(s), or a certificate of participation, your CME/CE certificate will be available for download.
Disclosure of Unlabeled Use
CMSC, NPA, and Catamount Medical Education require CME faculty to disclose when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty in this activity may discuss information about pharmaceutical agents that is outside of US Food and Drug Administration approved labeling. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. CMSC, NPA, and Catamount Medical Education do not recommend the use of any agent outside of the labeled indications. If you have questions, contact the Medical Affairs Department of the manufacturer for the most recent prescribing information.
CMSC, NPA, and Catamount Medical Education present this information for educational purposes only. The content is provided solely by faculty who have been selected because of recognized expertise in their field. Participants have the professional responsibility to ensure that products are prescribed and used appropriately on the basis of their own clinical judgment and accepted standards of care. CMSC, NPA, and Catamount Medical Education, and the commercial supporters assume no liability for the information herein.
Catamount Medical Education, LLC, respects your privacy. All personal information that is provided to Catamount Medical Education, LLC, is protected and will not be sold to a third party for commercial purposes. All personally identifiable information contained in the Catamount Medical Education, LLC, registration databases is treated as confidential and will be used only for the purposes stated in this policy, except where required by law. Catamount Medical Education, LLC, maintains user databases that contain mailing and user profile information as well as a record of the CME activities viewed and the post-test and evaluation results for CME/CNE credit. This information is provided to activity collaborators for the purposes of CME/CNE recordkeeping. By participating in this activity, you agree that Catamount Medical Education, LLC, has full permission to provide this information
If you have questions about this CME activity, please contact Catamount Medical Education at 860-661-4159 or firstname.lastname@example.org.