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Doctor Discussion Guide
Currently or previously treated MS
Medications I have used for MS:
I am currently using ___________________________________________________
(please enter the name of the medication(s) that you are currently using for your MS;
if you’re not sure, check the list below)
Check off all other medications you have used for your MS:
(check all that apply; if your medication is not on this list, write it in the blank spaces)
Avonex® (interferon beta-1a) Betaseron® (interferon beta-1b) Copaxone® (glatiramer acetate) Rebif® (interferon beta-1a) Tysabri® (natalizumab) corticosteroids (e.g., methylprednisolone [Solu-Medrol®], prednisone) other: _______________________________ other: _______________________________ other: _______________________________ I have some concerns about my current MS treatment:
I’m not sure how to use my MS treatment properly I’m having trouble mixing my MS medication or giving myself injections My injections are painful I’m anxious about seeing the needle when I give myself an injection I’m not sure whether my MS medication is really working I’m having trouble remembering to take my MS medication I think I’m having side effects from my MS treatment I sometimes forget to take my MS medication I’m not satisfied with my MS treatment Other: _______________________________ I’m interested in learning more about the following MS treatments:
Disease-modifying medications:
Avonex® (interferon beta-1a) Betaseron® (interferon beta-1b) Copaxone® (glatiramer acetate) Rebif® (interferon beta-1a) Tysabri® (natalizumab) corticosteroids (e.g., methylprednisolone [Solu-Medrol®], prednisone) other: ______________________________________ ______________________________________ ______________________________________ ______________________________________ I have some questions:
General questions about MS:
1. Which form of MS do I have?
2. How does MS progress? Is there any way to predict how my condition will change over time?
3. How will MS affect my daily life?
4. What is my score on the Expanded Disability Status Scale (EDSS)?
5. Do you have any tips for coping with MS? Are there any lifestyle changes that would
6. Where can I go for more information and support? Questions about MS treatment:
1. What treatment options are available to me?
2. Which treatments alter the natural course of the disease?
3. Why are MS therapies taken by injection?
4. Are there different injection schedules for the various MS drug treatments?
5. Are some MS medications easier to use than others?
6. Which treatment option would you recommend and why?
7. How does the treatment work?
8. How do I use the treatment properly and how often should I take it? 9. Does the treatment offer features that may make it easier to stay on therapy? 10. When will the treatment begin to work, and how long can I expect the treatment to keep 11. Has the treatment been proven to modify all three key measures of MS disease activity: disability, relapses, and MRI brain lesion activity* and area? 12. Has the treatment been proven to work better compared with another MS therapy 13. What are the side effects, and how should I manage them? 14. How long will I need to continue treatment? 15. Are there any side effects I should watch out for, and what should I do if they happen? 16. Does the treatment have a safety profile that is supported by long-term experience? 17. Will I need to have regular checkups or blood tests during treatment? 18. Are there any people who should avoid this treatment (e.g., people who are pregnant 19. Other: ________________________________ 20. Other: ________________________________ I would prefer a treatment that:
(check all that apply)
is clinically proven to reduce number and severity of relapses is clinically proven to slow the progression of disability is clinically proven to reduce the number and size of active brain lesions as seen can help prevent cognitive dysfunction (thinking and memory problems) from developing is less painful on injection causes less injection site swelling or redness *The exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.

Source: http://msvillagecanada.com/wp-content/uploads/2013/07/Doctor-Discussion-Guide-Currently-or-Previously-Treated-MS.pdf

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