Monograph: Moving Toward Improved Outcomes in MS: How PAs Can Make a Difference
This monograph is a supplement to the JAAPA October 2018 issue and outlines effective treatment practices for patients with multiple sclerosis. Also available,Clinical Dialogue and eCase Challenge Moving Toward Improved Outcomes in MS: How PAs Can Make a Difference.

Moving Toward Improved Outcomes in MS: How PAs Can Make a Difference

Lawrence Herman, MPA, PA-C, DFAAPA; Benjamin M. Greenberg, MD, MHS; Paula Hardeman, MPAS, PA-C, CRND

Multiple sclerosis is a chronic, debilitating illness that exacts a tremendous toll on patients’ functional abilities and quality of life. The diagnosis can often be challenging, as MS is frequently mistaken for a range of disorders, such as fibromyalgia or chronic fatigue syndrome. PAs can help improve the prospects for a timely and accurate diagnosis by increasing their awareness of MS symptoms and referring patients for more comprehensive evaluations when indicated. Once patients have commenced treatment, PAs can support patients’ prospects for maximum benefits by evaluating clinical responses, as well as side effects of treatment. As the therapeutic armamentarium for MS continues to expand, it is increasingly important that PAs be knowledgeable about the efficacy and safety of the range of disease-modifying treatments (DMTs) and how to monitor patients appropriately. Also of concern is the need for prompt recognition of the symptoms of relapse in patients with MS. Relapse has crucial implications, as it may not only undermine patients’ functional abilities, but reflect additional damage to the central nervous system. Throughout the course of the illness, adherence with therapy is essential if patients are to realize maximum benefits of treatment. Through their frequent interactions with patients, PAs can make major contributions by assessing and encouraging adherence, thereby helping patients achieve the best possible outcomes.  

Educational Objectives

At the conclusion of this activity, the PA should be better able to:
  • Identify and refer patients who have symptoms suggestive of multiple sclerosis (MS).
  • Apply knowledge of the efficacy and safety of disease-modifying therapies (DMTs) to the management of patients with relapsing-remitting multiple sclerosis (RRMS), including monitoring for adverse events.
  • Identify and refer patients with MS who show signs of relapse.
  • Evaluate patients for adherence to therapy for RRMS.

Accreditation Statement

This activity has been reviewed by the AAPA Review Panel and is compliant with AAPA CME Criteria. This activity is designated for 1.5 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation. Approval is valid through October 31, 2019.

Responsibility Statement

AAPA takes responsibility for the content, quality, and scientific integrity of this CME activity.

Disclosure Policy Statement

It is the policy of AAPA to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member has with the commercial interest of any commercial product discussed in an educational presentation. The participating faculty reported the following:


Lawrence Herman, MPA, PA-C, DFAAPA
Associate Program Director, Adjunct Professor
University of Texas Medical Branch - Galveston
School of Medicine, PA Studies
Galveston, TX
Disclosures: Consultant - Novo Nordisk; Speaker’s Bureau - Novo Nordisk

Benjamin M. Greenberg, MD, MHS
Vice Chair of Translational Research and Strategic Initiatives
Cain Denius Scholar of Mobility Disorders
Distinguished Teaching Professor
Department of Neurology and Neurotherapeutics
Department of Pediatrics
UT Southwestern Medical Center
Dallas, TX
Disclosures: Consultant - Novartis, Alexion; Grants/Research Support - Genentech, Chugai, Medimmune, Medday, NIH, PCORI, NMSS, GJCF

Paula Hardeman, MPAS, PA-C, CRND
Lead Advance Practice Provider
Neuroimmunology Program/Multiple Sclerosis Clinic
Department of Neurology and Neurotherapeutics
UT Southwestern Medical Center
Dallas, TX
Disclosures: Consultant - Sanofi Genzyme

Activity Planners

Michael Speidel, Nancy Baxter, and Joanne Jeffers, Medical Logix, LLC have no relationship with any commercial interests whose products or services may be mentioned during this presentation.

AAPA Staff Activity Planners

Daniel Pace has no relationship with any commercial interests whose products or services may be mentioned during this presentation.

Off-Label/Unapproved Product(s) Discussion

There are no references to off-label/unapproved uses of products in this program.


The opinions and comments 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. Please review complete prescribing information of specific drugs mentioned in this program including indications, contraindications, warnings, and adverse effects and dosage before administering to patients.

Acknowledgement of Commercial Support

Supported by independent educational grants from Biogen, Novartis Pharmaceuticals Corporation, and Sanofi Genzyme

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Type:     Internet Activity (Enduring Material)
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