Doctor Discussion Guide (for people currently on MS treatment)

Your neurologist (a doctor who specializes in treating MS and other conditions affecting the nervous system) can help you make sure you are getting the greatest possible benefit from your treatment so that you can live with MS to the best of your ability.

If you have questions about MS, are not sure how to use your treatment, or have questions or concerns about your current treatment, talk to your neurologist.

This Doctor Discussion Guide will help you talk to your neurologist about MS. Just fill in the blanks, then print your answers and bring them to your neurologist's visit.

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 (if your medication is not on this list, write it in the blank spaces). Check all that apply:

Avonex® PS (interferon beta-1a)
Betaseron® (interferon beta-1b)
Copaxone® (glatiramer acetate)
Extavia® (interferon beta-1b)
Gilenya® (fingolimod)
Rebif&® (interferon beta-1a)
Tysabri® (natalizumab)
corticosteroids (e.g., methylprednisolone [Solu-Medrol®], prednisone)
other: _______________________________
other: _______________________________
other: _______________________________

I have some concerns about my MS treatment:

I'm not sure how to use my MS treatment properly.
I'm having trouble taking my MS medication or giving myself injections.
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: _______________________________
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? What can I do to maintain my ability?
4. What is my Expanded Disability Status Score (EDSS)?
5. Do you have any tips for coping with MS? Are there any lifestyle changes that would help me manage my MS?
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 and help me preserve my ability?
3. Why are most MS therapies taken by injection?
4. What are the risks and benefits of each treatment option available to me?
5. Which treatment option would you recommend and why?
6. How does the treatment work?
7. How do I use the treatment properly, and how often should I take it?
8. When will the treatment begin to work, and how long can I expect the treatment to keep working for me?
9. How long will I need to continue treatment?
10. Are there any side effects I should watch out for, and what should I do if they happen?
11. Will I need to have regular checkups or blood tests during treatment?
12. Are there any people who should avoid this treatment (for example, people who are pregnant or breast-feeding)?
13. Other: ___________________________________
14. Other: ___________________________________

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