Reading List for Multiple Sclerosis Certified Nurses Exam
This list is compiled to help guide you in preparing for your exam, however it is not an
exhaustive list and you may need to read additional material.
Diagnosis
McDonald WI, Compston A, Edan G, et al. (2001) Recommended diagnostic criteria
for multiple sclerosis: guidelines from the International Panel on the Diagnosis of
Multiple Sclerosis.
Annals of Neurology 50(1) pp.121-7.
The International Panel on MS Diagnosis presents revised diagnostic criteria for multiple
sclerosis. Although diagnosis is still based on dissemination of lesions and clinical
methods such as magnetic resonance imaging, the revised criteria help to diagnose
patients who present with a number of symptoms. Previous terms such as "definite" and
"probable" are no longer acceptable. Instead MS, "possible MS" or "not MS" are
preferable.
[Ref. 2427]
Polman CH, Reingold SC, Edan G et al. (2005)
Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”.
Annals of Neurology 58(6) pp.840-46.
New evidence and consensus strengthen criteria to dissemination of lesions in time,
clarify use of spinal cord lesions and simplify diagnosis of primary progressive MS.
[Ref. 3894]
Johnson J. (2003).
On receiving the diagnosis of multiple sclerosis. Managing the transition. Multiple
Sclerosis 9(2) pp.82-88.
Based on in depth interviews with 24 patients who have MS, the insights gained around
experiences of diagnosis are discussed. Findings highlight feelings of abandonment and
isolation, possibly resulting from differing expectations between neurologist and patient. It
is suggested that imparting the diagnosis should be seen as the start of a transition for
the patient that should be linked to provision of information advice and ongoing support as
people learn to live with and manage the condition.
[Ref. 3138]
Relapse management
Chataway J, Porter B, Riazi A, et al. (2006)
Home versus outpatient administration of intravenous steroids for multiple
sclerosis: a randomised controlled trial.
Lancet Neurology 5(7) pp.565-571.
Trial of 138 patients presenting within four weeks of onset of clinically significant relapse.
Patients were randomly assigned to a three day regime of intravenous
methylprednisolone either in an outpatient setting or at home. Steroids were found to be
equally safe and effective when given in either location, and cost was either the same or
cheaper at home. Concludes that IV steroids can be safely and effectively delivered in the
home [Ref. 4041]
Disease modifying therapies
Association of British Neurologists (Revised) 2009 guidelines for prescribing in
multiple sclerosis.
www.theabn.org/abn/userfiles/file/ABN_MS_Guidelines_2009_Final.pdf
(accessed 20/01/10)
In 2001 the ABN published the first guidelines for use of licenced disease modifying
treatments in MS which were subsequently revised in 2007. This revision takes account
of studies on treatments for multiple sclerosis published since the 2007 revision and aims
to represent a national consensus concerning the use of currently approved disease
modifying drugs in multiple sclerosis..
Multiple Sclerosis Consensus Group (MSTCG) (2008)
Basic and escalating immunomodulatory treatments in multiple sclerosis: current
therapeutic recommendations.
Journal of Neurology 255(10) pp.1449-1463.
This review makes recommendations on treatment with beta interferons in the context of
comparative studies. The use of natalizumab and the open questions that remain are
considered and the use of intravenous immunoglobulins, mitoxantrone, and azathioprine
examined in light of current evidence. Early initiation of immunotherapy is recommended
but the importance of providing patients with information regarding realistic therapeutic
goals, mechanisms of action and possible side effects is stressed. [Ref. 4641]
Fatigue
Lee D, Newell R, Ziegler L, et al (2008).
Treatment of fatigue in multiple sclerosis: a systematic review of the literature.
International Journal of Nursing Practice 14(2)pp. 81-93.
Systematic review revealed 15 intervention studies on fatigue (10 pharmacological , 5
psychological) which met inclusion criteria as being RCT, open label or cross-over trials
that examined fatigue in MS as an outcome measure. Of these only two were deemed
moderate to high quality. Concludes that little evidence based advice can be offered to
people with MS and suggests further studies over a broad range of interventions using
research addressing the methodological difficulties highlighted. Contains detailed tables
of all studies included with methodologies, participants and conclusions. [Ref. 4581]
MacLean R. (2006)
Fatigue in multiple sclerosis: a common, hidden symptom requiring regular
assessment.
British Journal of Neuroscience Nursing 2(2) pp.66-72
Considers the multidisciplinary assessment and management of fatigue and examines
how the principles of fatigue management can address recommendations made in NICE
guidance and the quality requirements of National Service Framework for long term
conditions. [Ref. 3994]
Bladder management
Fowler CJ, Panicker JN, Drake M, et al. (2009)
A UK consensus on the management of the bladder in multiple sclerosis.
Journal of Neurology Neurosurgery Psychiatry 80(5) pp. 470-477
Recommendations based on review of the literature and expert opinion using NICE
criteria. Consensus highlighted that patients with MS who experience bladder symptoms
should be assessed by an expert and encouraged to understand why they have
developed poor bladder control. Successful management could be based on a simple
algorithm including reagent sticks to test for urinary tract infections and post micturation
residual volume measurement. The mainstay of treatment is antimuscaric medications in
combination, where necessary, with clean intermittent self catheterisation. [Ref. 4738]
Cognition
Halper C, Kennedy P, Miller CM, et al. (2003)
Rethinking cognitive function in multiple sclerosis: a nursing perspective.
Journal of Neuroscience Nursing 35(2) pp.70-81
Cognitive dysfunction in MS is often undiagnosed or misdiagnosed and the position of the
nurse in identifying these patients and their role in educating people and their families on
ways to cope with cognitive deficits is highlighted. Case studies and practical guidelines
are included. [Ref. 3170]
Prakash RS, Snook EM, Lewis JM, et al. (2008)
Cognitive impairments in relapsing remitting multiple sclerosis: a meta analysis.
Multiple Sclerosis 14(9) pp. 1250-1261.
57 studies were included with 3891 participants in total. Moderate decline in cognitive
functioning was found in individuals with RRMS compared to healthy controls across all
domains of cognitive functioning. Age and gender were moderators of cognitive
impairment in all domains and neurological disability and disease duration affected
performance in areas of memory and learning. The need to identify strategies to mitigate
cognitive impairment in MS is highlighted. [Ref. 4643]
Spasticity
Birns J, Fitzpatrick M. (2008)
Management of spasticity: a brief overview of educational and pharmacological
therapies.
British Journal of Neuroscience Nursing 4(8) pp. 370-373.
Overview examines patho-physiology of spasticity, effect on lifestyle and methods of
assessment. Multidisciplinary team involvement in setting realistic treatment goals,
managing expectations, and working in partnership with the patient, family and caregivers
is highlighted. The roles of non pharmacological management offered by physiotherapy
and occupational therapy and pharmacological treatments including oral medication, focal
treatments, intrathecal baclofen and surgical techniques are examined. [Ref. 4643]
Thompson AJ, Jarrett L, Lockley L et al. (2005)
Clinical management of spasticity.
Journal of Neurology Neurosurgery and Psychiatry 76 pp.459-61.
Considers physical and pharmacological treatments that reduce pain and discomfort
without compromising function and highlights the importance of multidisciplinary
involvement. Includes an algorithm of spasticity management. [Ref. 3709]
Practice development
Ennis M, Shaw P, Barnes F, et al. (2008)
Developing and auditing multiple sclerosis relapse management guidelines.
British Journal of Neuroscience Nursing 4(6) pp. 266-271.
Guidelines on the management of acute relapses developed and implemented in South
London were followed by an audit Considers the case for oral vs intravenous steroid
treatment and includes both an algorithm for management of acute relapses and a patient
information sheet for treatment of relapse.
[Ref. 4572]
Matheson F, Porter B. (2006)
The evolution of a relapse clinic for multiple sclerosis: challenges and
recommendations.
British Journal of Neuroscience Nursing 2(4) pp.66-72.
Development of a nurse led clinic within the multidisciplinary team that considers inpatient
support and education, telephone triage and the development of an integrated care
pathway. [Ref. 4030]
Service use and costs
McCrone P, Heslin M, Knapp M, et al. (2008)
Multiple sclerosis in the UK: service use, costs, quality of life and disability.
Pharmacoeconomics 26(10) pp. 847-860.
Questionnaire study of 1942 people with MS covered personal and social circumstances,
use of health and social care services, health status and disability level. Average cost for
the preceding six months was £8,397 with only 8% due to use of DMTs and spasticity
medications. Lost employment costs over this period were £4,240 and the high economic
cost borne by informal carers is highlighted.
[Ref. 4611]
Compiled by Lynn Fox Information Officer 20/01/10
lynn.fox@mstrust.org.uk