Sponsored by the Postgraduate Institute for Medicine
Release date: September 12, 2007
Expiration date: September 12, 2008
Estimated time to complete activity: 15 minutes
This educational program is supported through educational grants from Biogen IDEC and Elan Pharmaceuticals Inc.
Program Overview:
Several disturbances in thought processes occur in persons with MS, including slowed cognition, impaired concentration and memory, loss of complex language, and impaired problem solving and decision-making capacity. There is no simple tool available to assess subtle cognitive losses in primary care settings. The clinician can screen for such problems with a sensitive inquiry regarding any changes in the patient’s ability to remember appointments, focus on tasks, or recall conversations. If indicated, the patient should be referred for a full neuropsychological battery of tests, which takes about 1-2 hours. Clinical trial data suggest that disease-modifying agents used in MS that slow disease progression may also slow cognitive decline. Early diagnosis of cognitive problems also enables clinicians to refer early for rehabilitation and appropriate therapies.
Target Audience:
This activity has been designed to meet the educational needs of neurologists, physicians and nurses involved in the management of patients with multiple sclerosis.
Learning objectives:
Upon completion of this activity, the participant will be able to:
• Cite the nature of cognitive dysfunction affecting some patients with multiple sclerosis.
• Identify neuropsychological screening tests used to assess cognitive impairment in patients with multiple sclerosis.
• Name a treatment that has been found in a study to provide significant improvement on memory testing for patients with patients with cognitive impairment.
Program Co-Chairs:
Robert J. Fox, MD
Staff Neurologist
The Cleveland Clinic
Cleveland, Ohio
Robert J. Fox, MD, is a staff neurologist at the Cleveland Clinic Foundation in Ohio. He is also the director of the Mellen Center MS tissue donation program.
Dr. Fox received his undergraduate degree from Amherst College and his medical degree from Johns Hopkins University. He pursued residency training in neurology at the Hospital of the University of Pennsylvania in Philadelphia. Dr. Fox completed clinical training as a Potiker Fellow at the Mellen Center for Multiple Sclerosis Treatment and Research at the Cleveland Clinic Foundation.
Nilay Shah, MD
Director, Neurology Division
Riverfront Medical Associates
Edgewater, NJ
Nilay Shah, MD, is in private practice in the metro New York area. He also teaches neurology as an assistant professor in neurology at St. George's University School of Medicine. He previously had a private practice in upstate New York, and ran a clinic for patients with multiple sclerosis about 60 miles northwest of New York City for nearly three years.
Dr. Shah is a founding member and director of communications for the New York State Neurological Society, and also sits on the advisory board for the MS Society of Southern New York State. His other interests include the use of technology in healthcare, and he's given a number of lectures at medical society meetings around the country as co-founder and CIO of MedicalPocketPC.com, a website for healthcare professionals using handheld technology to improve patient care.
After getting his undergraduate degree at Cornell University and finishing medical school at St. George's University, Dr. Shah went on to a Neurology Residency at Mt. Sinai Medical Center. He completed a Neurophysiology Fellowship at the University of Pittsburgh.
Author:
Jeffrey A. Wilken, PhD
Assistant Professor of Neurology
Georgetown University Medical Center
Washington, DC
Dr. Jeffrey Wilken is an Assistant Professor of Neurology at the Georgetown University Medical Center. He is also Director of the Washington Neuropsychology Research Group and Director of Research at Neuropsychology Associates of Fairfax. Dr. Wilken received his B.S. from Cornell University, and his M.A. and Ph.D. from the University of Maryland at College Park. He completed pre-doctoral training at the NIH, Walter Reed Army Medical Center, Johns Hopkins Outpatient Center, and the VA Medical Center in Baltimore, MD. He completed post-doctoral training at Georgetown University Medical Center. Dr. Wilken is currently the primary investigator in charge of multi-center, funded studies looking at the cognitive sequelae of multiple sclerosis (MS), the utility of computerized assessment for patients with MS, and the efficacy of combination therapy in the treatment of breakthrough cognitive problems in MS patients. He has authored numerous peer-reviewed journal publications and published abstracts. His research has been presented at national and international scientific conferences, including: American Neurological Association, American Academy of Neurology, and the Consortium of Multiple Sclerosis Centers. Dr. Wilken is a member of the American Academy of Neurology, Consortium of Multiple Sclerosis Centers, National Academy of Neuropsychology, International Neuropsychological Society, and American Psychological Association. He is also on the clinical advisory board for the Washington, D.C. chapter of the National Multiple Sclerosis Society and he is a reviewer for a number of scientific journals.
Instructions for Credit
Physician Continuing Education
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Healthology, Inc. PIM is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
The Postgraduate Institute for Medicine designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.
PIM is an approved provider of continuing nursing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
California Board of Registered Nursing
Postgraduate Institute for Medicine is approved by the California Board of Registered Nursing, Provider Number 13485 for 0.25 contact hours.
Fee Information
There is no fee for this educational activity.
Disclosure of Conflicts of Interest
The Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements of quality in healthcare and not a specific proprietary business interest of a commercial interest.
The following faculty reported a real or apparent conflict of interest:
Robert J. Fox, MD (Co-Chair) Type of financial relationship: Consultant Grants/Research Support and Honorarium for: Genentech, Merck, Biogen IDEC, Questcor and TevaNeuroscience
Nilay Shah, MD (Co-Chair): Has no relevant information to disclose.
Jeffrey A. Wilken, PhD (Author): Type of financial relationship: Speaker’s Bureau: Biogen; Consultant Grants/Research Support: Biogen, Schering Plough, and Cognition Pharmaceuticals
The following planners and managers reported a real or apparent conflict of interest:
Carol A. Smyth, MB BCh BAO (Healthology) No financial interest/relationships relating to the topic of this activity.
Jan Hixon, RN, BSN, MA (PIM) No financial interest/relationships relating to the topic of this activity.
Method of Participation
There are no fees for participating and receiving CME credit for this activity. During the period September 12, 2007, through September 12, 2008, participants must: 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the post-test by recording the best answer to each question in the answer key on the evaluation form; and 4) complete the evaluation form.
A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed post-test with a score of 70 percent or better. Your statement of credit will be mailed to you within three weeks.
Media
Internet
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The Postgraduate Institute for Medicine (PIM), Healthology Inc., and Biogen IDEC and Elan Pharmaceuticals Inc. do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, Healthology Inc., and Biogen IDEC and Elan Pharmaceuticals Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.
Produced by Healthology Inc. © 2007
Sponsored by the Postgraduate Institute for Medicine
Supported through educational grants from Biogen IDEC and Elan Pharmaceuticals Inc.