Program Overview
MS being a chronic disease, having effective treatments but no cure, symptom management becomes critically important as certain symptoms occur regularly regardless of treatment. The model that provides optimal results for patients with MS is a multimodal approach using effective communication, patient education, physical activities, occupational and other therapies, and pharmacologic interventions. A team approach facilitates coordination of services and continuity of care, and avoids duplication and fragmentation for the patient and the family. The comprehensive care team in MS consists of a well-informed patient and care partners, including neurologist, nurses, social workers, physical therapists, occupational therapists, speech language pathologists, and psychologists among others. This program will emphasize the importance of the team approach to patient care and outline for the professionals involved a model of integration of care that holds the patient at the center.

Program Format
An Internet-based, CE-accredited professional education program.

Target Audience
This program has been developed for MS-treating physicians, nurses, and pharmacists. There are no prerequisites to participate in this activity.

Educational Objectives
At the conclusion of this activity, participants should be better able to:

• Describe the patient-centered model of care as it is used in patients with MS
• Outline the components of the symptom management approach to care in MS
• Delineate other issues that impact symptom management, such as adjustment to diagnosis and adherence
• Characterize the members of a comprehensive care team as it functions in an MS clinic setting
• Incorporate the patient-centered approach into the participant’s care setting

Disclaimer
The opinions and recommendations expressed by faculty and other experts, whose input is included in this program, are their own. This enduring material is produced for educational purposes only. Use of The Institute for Johns Hopkins Nursing name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

CE Information
The Institute for Johns Hopkins Nursing is accredited as a provider of continuing education in nursing by the American Nurses Credentialing Center Commission on Accreditation.

Credit Designation
The Institute for Johns Hopkins Nursing designates this activity for a maximum of 1.2 contact hours. Claim only those contact hours actually spent in the activity.

Date of Release and Expiration
This course was released on August 2005 and will expire on August 2006. CE credit cannot be awarded after this date. Estimated time to complete this educational activity: 1 hour.

Responsibility Statement
The Institute for Johns Hopkins Nursing takes responsibility for the content, quality and scientific integrity of this CE activity.

Privacy Statement
The Institute for Johns Hopkins Nursing (IJHN) is committed to protect the privacy of our participants. We maintain our internet site as an information resource and service for health professionals. The Institute for Johns Hopkins Nursing will keep your personal information confidential when you participate in an internet based program. Your information will never be given to anyone outside of the IJHN continuing education programs. The Institute for Johns Hopkins Nursing collect only the information necessary to provide you with the services that you request.

Faculty

Peggy Crawford, PhD
Mellen Center
Cleveland Clinic Foundation

After completing her master’s degree in pediatric nursing at Case Western Reserve University, Peggy Crawford worked for nearly a decade at Rainbow Babies and Children’s Hospital as a pediatric nurse clinician in the area of diabetes and endocrinology. It was during this time that she developed her longstanding interest in how individuals and families cope with the day-to-day demands and challenges of chronic illness. After completing a PhD in clinical psychology at Kent State University and an internship in health psychology, she completed a year of postdoctoral training in health psychology at the Mellen Center for MS Treatment and Research at the Cleveland Clinic Foundation. For the next year, she was a faculty member in the department of family medicine at Case Western Reserve University where her responsibilities included training family practice physicians in the behavioral science component of patient care.

Since 1993, she has been a member of the professional staff at the Mellen Center where she is responsible for health psychology services including assessment and treatment (individual and group therapy) of individuals referred for a variety of concerns including emotional distress, stress-related symptoms, coping difficulties, and fatigue. She has conducted research on depression in patients taking beta interferon, group psychotherapy as a treatment modality in chronic illness, and psychosocial outcomes in MS and epilepsy surgery patients. Her publications have focused on issues related to coping with chronic illness and the psychological aspects of MS including depression and the special challenges involved in parenting with MS. Her ongoing interests include the identification of factors that contribute to effective coping with chronic illness, the impact of depression, and issues unique to women with chronic illness.

Gloria J. Morin, OTR/L
Cleveland Clinic Foundation, Cleveland Ohio
VA Medical Center, Cleveland Ohio, Stroke Research Team

Gloria J. Morin, OTR/L received her Master in Occupational Therapy degree from Texas Woman's University in Denton Texas. She has worked in a variety of settings, mainly with adults with neurological disorders. She has completed the Neuromuscular Developmental Treatment Certification program and training as an Assistive Technology Practitioner.

Ms. Morin has been an employee of the Cleveland Clinic Foundation for 10 years, the past two as a member of the interdisciplinary treatment team at the Mellen Center for Multiple Sclerosis Treatment and Research. In June, 2005, Ms. Morin began a full time research position at the Louis Stokes VA Medical Center in Cleveland. She has participated in student education programs and spoken to various support groups in the Cleveland area.

Marie Namey, RN, MSN, MSCN
Clinical Nurse Specialist
The Cleveland Clinic Foundation

Marie A. Namey, RN, MSN, received her MSN from The Frances Payne Bolton School of Nursing at Case Western Reserve University. She received her BS in nursing from Villa Maria College, Erie, Pennsylvania.

Ms. Namey has been part of the interdisciplinary team at the Mellen Center for Multiple Sclerosis Treatment and Research at The Cleveland Clinic Foundation since its inception in 1985. She is a member of the local MS Society chapter professional advisory committee and the chapter program committee. She is a popular speaker for patient and professional groups on aspects of MS care.

Ms. Namey is a member of advisory groups for pharmaceutical companies. She is on the Editorial Board for Real Living with MS. She has published on topics of bladder and bowel function and adherence. She has been a member of the Consortium of Multiple Sclerosis Centers since 1986 and has served as secretary, vice president, and president of this organization. She was chair of the education committee and participated on the education committee and abstract review Committee. She currently chairs the advocacy committee.

Ms. Namey is a founding member and currently is treasurer of the International Organization of Multiple Sclerosis Nurses.

Patricia Provance, PT, MSCS
Senior Physical Therapist
Kernan Rehabilitation Hospital & Maryland Center for MS Baltimore, Maryland

Patricia G. Provance, PT, MSCS, has been a practicing clinical physical therapist for 34, and she is a multiple sclerosis certified specialist. She is a National Multiple Sclerosis Society clinical consultant and was selected to their Volunteer Hall of Fame. In 1982 at the Union Memorial Hospital, Patricia developed the first MS rehabilitation program in Maryland. Since 2000, she has worked as an MS specialist at Kernan Orthopaedic and Rehabilitation Hospital and the Maryland Center for MS in Baltimore.

Katherine Treadaway, LCSW
Social Worker
UT Southwestern Clinical Center for Multiple Sclerosis

Katherine Treadaway, LCSW, attended Louisiana State University for graduate and undergraduate school.

Katherine started working at the UT Southwestern Multiple Sclerosis clinic in September 2002. She helps patients by locating resources, providing counseling and education, arranging home care, assisting with forms and getting medications for people without prescription coverage. Katherine is working on her own study with Elliot Frohman, MD, on what factors influence people taking their injectable medicationsThis year she rode in the NMSS Lonestar chapter’s Red River Challenge with her team, The Chain Gang. She works with a dynamic team and is fortunate to use her medical social work skills in the MS Clinic.

Faculty Disclosures

Full Disclosure Policy Affecting CE Activities
As a sponsor accredited by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC), The Institute for Johns Hopkins Nursing must ensure balance, independence, objectivity, and scientific rigor in all its individually-sponsored or jointly-sponsored educational activities. All faculty participating in a sponsored activity are expected to disclose to the activity audience any significant financial interest or other relationship (1) with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. (Significant financial interest or other relationship can include such things as grants or research support, employee, consultant, major stockholder, member of speakers bureau, etc.). The intent of this disclosure is not to prevent a presenter with a significant financial or other relationship from making a presentation, but rather to provide listeners with information on which they can make their own judgments. It remains for the audience to determine whether the presenter's interests or relationships may influence the presentation. In addition, presenters must make a meaningful disclosure to the audience of their discussion of unlabeled or unapproved drugs or devices.

Peggy Crawford, PhD has no relationships to disclose.

Gloria Morin, OTR/L has no relationships to disclose.

Marie Namey, RN, MSN, MSCN has served as a consultant for Biogen Idec, Teva Neuroscience, and Serono Inc. She has also received honorarium from Biogen Idec, Teva Neuroscience, and Serono Inc.

Patricia G. Provance, PT, MSCS has received grant and research support from Biogen Idec.

Katherine Treadaway has received grant and research support from Biogen Idec

Off-Label Discussion
This program mentions the experimental use of rituximab in multiple sclerosis. Rituximab has not been approved by the FDA for this use.

No faculty member has indicated that their presentation will include information on off-label products.

This educational program is supported through an educational grant from Biogen Idec and Elan Pharmaceuticals.

Copyright 2005, The Institute for Johns Hopkins Nursing. All rights reserved.

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