American Academy of Neurology Institute quality improvement update for MS

The American Academy of Neurology Institute (AANI) has released an update to the 2020 Quality Measurement Kit, which aims to improve care and outcomes for patients with multiple sclerosis (MS), according to an update posted in Neurology.

MS, a chronic disease, was diagnosed more often than forecast in 2010 and remains one of the most expensive diseases. There were approximately 914,000 people with MS in the United States in 2017, and treatment costs were $ 13.9 billion in 2016. To ensure that patients with MS receive the best care, the AANI reviews its quality measurement recommendations every three years.

Based on a literature review and an open public comment period, the AANI committee agreed on 6 measures to be included in the 2020 update and withdrew 7 measures.

Continue reading

For patients with pre-existing disease who had been examined by magnetic resonance imaging (MRI) within the past 24 months, the committee recommended continued MRI monitoring. This action should fill a gap in care, ensure that patients receive the most appropriate treatment, and allow for timely changes if needed.

In its update, the committee also recommended that patients treated with disease-modifying treatments be monitored for side effects and compliance. Current recommendations relate to monitoring at the beginning of the course of treatment; however, continued monitoring can result in greater quality of life improvements.

Screening for bowel, bladder, and sexual dysfunction should be done annually as up to 90% and 80% of men and women with MS have sexual dysfunction, respectively. These symptoms are often overlooked and can have a major impact on mental health and quality of life.

Patients with MS should also be evaluated for cognitive impairment and fatigue, since up to 70% and 80% of patients with MS have cognitive deficits and chronic fatigue, respectively. The authors of the update warned that impairment should be examined with MS-specific instruments, since standard neurological examinations for patients with MS are not sensitive enough and that the cause of fatigue for MS patients is often multifactorial.

Finally, the committee recommended that patients with MS receive exercise counseling to optimize their physical health.

The withdrawn measures included aspects of MS diagnosis, disability scale, fall risk screening, fatigue outcome, depression screening and the basic assessment of quality of life.

The AANI Committee concluded that these quality assurance measures will improve the care and neurological outcomes of patients with MS.

Disclosure: Several authors stated links to the pharmaceutical industry. For a full list of the details, see the original article.


Rae-Grant A, Amezcua L, English J, et al. Quality Improvement in Neurology: Multiple Sclerosis Quality Measurement Set 2020 Update. Neurology. 2021; 97 (3): 134-141. doi: 10.1212 / WNL.000000000000012124

Related Articles