Effectiveness of Series-Based Online Education in Multiple Sclerosis: Planned and Actual Changes to Improve Mobility Management

Background: Mobility impairment, one of the most recognized physical characteristics of MS, is ranked as a high priority among patients’ concerns. Yet clinicians remain challenged in adequately assessing and treating mobility impairment and its symptoms, including gait problems, spasticity, muscle weakness, fatigue, pain, and balance impairment.  

Objectives: A study was conducted to determine if a series of online educational interventions designed to address this gap could improve clinician practices.

Methods: Medscape Education and Multiple Sclerosis Association of America developed 3 CME/CE online interventions for neurologists, primary care physicians, and nurses. The impact of these activities on self-reported physician practices related to mobility management was measured via a follow-up Planned Change Assessment®.  Learners were asked to complete the survey immediately after each activity (ie, identify planned changes), and 6-8 weeks later to measure actual self-reported changes in practice. Survey participants’ stated intentions were compared with reported actual changes in performance, and barriers to implementing changes were assessed.

Results: 8547 US participants completed the survey, 2419 of which indicated that they planned to make 7735 changes, or an average of 3.2 changes per participant. Of the 2419, 88 completed the follow-up survey 6-8 weeks later, 76 (86%) of which reported making an average of 3.5 clinical changes in practice while the rest indicated already following best practice recommendations. Most changes in practice focused on using best practices for early intervention to preserve ambulation and identification of symptoms impacting mobility including intervening earlier to preserve ambulation, identifying symptoms that negatively affect mobility, and addressing social needs that may affect mobility. Lack of tools to assess mobility and ready access to a multidisciplinary team were barriers chosen by most participants at the immediate post-activity survey, while the barrier most negatively impacting change on the follow-up survey was social issues such as lack of modified housing, adaptive equipment, or accessible transportation. 

Conclusions: The educational metrics gathered in this assessment are a strong indicator that these interventions prompted changes in clinical performance. Participants were motivated to make measurable changes related to managing mobility in MS commensurate with the learning objectives of the program.