Multiple Sclerosis Counseling Points - Spring 2015
Encouraging Monitoring and Follow-up in MS Care

Continuing Education Post-test

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33% of survey complete.

To receive contact hours, please read the program in its entirety, answer the following post-test questions, and complete the program evaluation. A certificate will be awarded for a score of 80% (8 correct) or better. A certificate will be mailed within 4 to 6 weeks. There is no charge for CNE credit.

PLEASE SELECT THE BEST ANSWER

Question Title

1. Patients with multiple sclerosis (MS) who are on disease-modifying therapy (DMT) should be monitored for safety and adverse effects of therapy:

a. at initiation of therapy and after 6 months

b. at initiation of therapy, after 3 months, and then every 6 months thereafter

c. only if the patient complains about adverse effects or if lab results are abnormal

d. this determination must be individualized for the specific DMT and the patient’s circumstances

Question Title

2. A patient with MS in your practice has been prescribed a DMT, but 3 months later has not yet filled the prescription. An appropriate course of action would be:

a. call the pharmacy and ask them to contact the patient

b. wait another 3 months and then follow up to see if the patient has started on the drug

c. follow up to determine whether insurance limitations or prior authorization requirements may be causing a delay

d. assume that the patient is not yet ready to commit to regular use of a DMT

Question Title

3. Electrocardiogram (ECG) and heart rate monitoring are part of the safety monitoring protocol for:

a. fingolimod (Gilenya)

b. natalizumab (Tysabri)

c. alemtuzumab (Lemtrada)

d. teriflunomide (Aubagio)

Question Title

4. Monthly liver function testing is recommended for patients receiving which of the following DMTs?

a. glatiramer acetate (Copaxone)

b. interferon beta 1b (Betaseron)

c. dimethyl fumarate (Tecfidera)

d. teriflunomide (Aubagio)

Question Title

5. Among patients receiving a DMT, complete blood count (CBC) is recommended:

a. mainly for those on an immunosuppressive agent such as alemtuzumab

b. only for those receiving an interferon

c. for most patients, as a way to monitor immune cell response and infection risk

d. primarily for patients with low white blood cell counts at initiation of therapy

Question Title

6. Progressive multifocal leukoencephalopathy (PML) is caused when:

a. immunosurveillance of the central nervous system (CNS) is blocked or inhibited

b. JC virus proliferates in the CNS

c. JC virus invades oligodendrocytes in the CNS

d. all of the above

Question Title

7. True or False? Leukopenia due to treatment with interferon-based DMTs has been associated with serious opportunistic infections among patients with MS.

a. True

b. False

Question Title

8. In discussing risk acceptance with a patient in regard to a new MS therapy, the MS nurse should always:

a. recognize that younger people are more open to accepting risk

b. take into account the patient’s level of health literacy

c. try to play down some of the least-likely, serious risks of DMTs

d. encourage the patient that it’s worth taking on some greater health risks for better disease control

Question Title

9. Research about medication use in general shows that patients:

a. underestimate common risks

b. overestimate serious risks

c. have an accurate view of how adverse effects may impact their health

d. both (a) and (b) above

Question Title

10. Potential adverse effects of MS DMTs:

a. are well understood based on pre-approval clinical trial data

b. may not become apparent until after several years of postmarketing use

c. are usually outweighed by the efficacy potential of the drug

d. can always be detected early through monitoring