The solution I've found to be best involves:
- Creating the project's specification Word file (it's heavily formatted)
- copy/pasting into an Mtext in AutoCAD
- configuring the columns to fit within our content-area of the titleblock (i.e. a 36x24 sheet might use 30.9" wide x 21.5" high viewing area, I would use 4.65" wide columns, 0.5" gutter, and 20" height)
- Draw a rectangle ON A NON-PRINT LAYER the size of the mview. This helps align the text. (I move Mtext block to top-left of rectangle, then down 0.75", then over 0.25" - that's 1/2(mview height - column height) and 1/2(gutter width), respectively).
- Creating a "sheet" that has the mview on a NON-PRINT LAYER - (in above example, the mview is 30.9" x 21.5" and would be aligned within the 36x24 area to fit the titleblock. To size an mview, draw a sized rectangle first, then align the mview)
- To align mview contents, double click in mview, type zoom{enter} then o{enter} to zoom object. Select the rectangle drawn in step 4, then change your view scale to 1:1 - it's a perfect fit!
- Duplicate this sheet until all specs are covered. (Right click tab > Copy > double click within mview, type -p{Enter} for pan, then pan the width of your mview; 30.9" in example)
- Print all spec sheets to PDF
- Convert PDFs to PNG images (300 dpi works well without bloating the file size)
- Import images to Revit (drag & drop onto your Revit sheet works fine)
- Select the image and scale to match your sheet width (36 in example)
- Align with your titleblock
- Send image to the back
- You now have one image per spec. sheet that will print and display properly from within Revit.
Note: To revise your specs, you'll need to:
- update your Mtext in AutoCAD
- reprint the sheets
- convert them to images
- update the image through Manage Images in Revit (no need to scale/realign again).
The only thing on my Christmas wish list is for Revit to integrate actual text capabilities like AutoCAD has.

Screenshots of my AutoCAD model space and sheet:
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