Identification of clinician challenges in order to drive the development of competency-based education: results from an international needs assessment in multiple sclerosis

Hayes, Sean M.; Sharief, Mohammed; Ng, Pamela

doi:10.3402/jecme.v4.27432

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Patients whose healthcare providers respond positively and who provide feedback about their needs, views and concerns are more likely to participate in shared decision-making [ 59 ]. However, studies have shown that doctors and nurses who care for patients with MS sometimes do not have the appropriate knowledge and skills to encourage patients to actively participate in the treatment process [ 73 ]. Therefore, medical personnel should be trained in the communicative and psychological competences in communicating with patients.…”

Section: Adherencementioning

confidence: 99%

Adherence to Therapy in Patients with Multiple Sclerosis—Review

Kołtuniuk

Chojdak-Łukasiewicz

2022

IJERPH

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Multiple sclerosis (MS) is a chronic, autoimmune, demyelinating disease of the central nervous system (CNS). MS is an incurable disease. The goal of disease-modifying therapies (DMT) is to slow the progression of the disease, prevent relapses and increase the patient’s overall quality of life. According to the World Health Organisation definition, adherence means the extent to which a person’s medication-taking behaviour corresponds with the agreed upon treatment recommendations from a healthcare provider. Accurate adherence is necessary for efficient treatment. Non-adherence is related to unsuccessful treatments, the risk of relapses and increased healthcare costs. The aim of this study is to present the main factors relating to non-adherence in MS patients.

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Section: Adherencementioning

confidence: 99%

Adherence to Therapy in Patients with Multiple Sclerosis—Review

Kołtuniuk

Chojdak-Łukasiewicz

2022

IJERPH

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“…However, the same participants self-reported significant deficits in their abilities to engage patients and/or caregivers in SDM due to insufficiencies in knowledge, skill, and confidence. These results suggest that continuing medical education and performance improvement initiatives should be implemented and would be welcomed by practitioners caring for patients with MS. 40 However, the additional time and resources required for training may be an impediment to implementation of such programs. 37 Nonclinical factors, including costs and health care barriers, can also affect adherence and SDM.…”

Section: Sdm and Patient-provider Relationshipmentioning

confidence: 99%

Impact of Shared Decision Making on Disease-Modifying Drug Adherence in Multiple Sclerosis

Ben-Zacharia¹,

Adamson²,

Boyd³

et al. 2018

International Journal of MS Care

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CME/CNE Information Activity Available Online: To access the article, post-test, and evaluation online, go to http://www.cmscscholar.org. Target Audience: The target audience for this activity is physicians, physician assistants, nursing professionals, and other health-care providers involved in the management of patients with multiple sclerosis (MS). Learning Objectives: Accreditation Statement: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Delaware Media Group. CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Physician Credit The CMSC designates this journal-based activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurse Credit The CMSC designates this enduring material for 1.0 contact hours (none in the area of pharmacology). Disclosures: , Editor in Chief of the International Journal of MS Care (IJMSC), has served as Physician Planner for this activity. He has received royalties from Springer Publishing, served on a speakers' bureau for Biogen, and done contracted research for Adamas Pharmaceuticals.Francois Bethoux, MD , has served as reviewer for this activity. She has disclosed no relevant financial relationships.Laurie Scudder, DNP, NP , has received consulting fees from Biogen, Bayer, EMD Serono, Celgene, Novartis, Genentech, and Genzyme and research grants from Biogen and Novartis.Aliza Ben-Zacharia, DNP, ANP, MSCN , has served on speakers' bureaus for Biogen, EMD Serono, Genentech, Novartis, Genzyme, Acorda, Teva, and Mallinckrodt.Meagan Adamson, DNP, FNP-BC, MSCN , has received consulting fees from Genzyme, served on a speakers' bureau/advisory board for EMD Serono, and has been a speaker for Teva Neurosciences and Biogen.Allison Boyd, MPAS, PA-C, MSCS , has disclosed no relevant financial relationships.Paula Hardeman, MPAS, PA-C , has served on advisory boards for Biogen, EMD Serono, Genentech, Novartis, Sanofi Genzyme, and Teva Neuroscience and as a speaker for EMD Serono, Genentech, Mallinckrodt, Sanofi Genzyme, and Teva Neuroscience; she receives salary from Biogen.Jennifer Smrtka, MSN, ARNP-C, MSCN , has received consulting fees from Biogen, EMD Serono, and Sanofi Genzyme and served on speakers' bureaus for Novartis and Biogen.Bryan Walker, MHS, PA-C , has received grant support from EMD Serono, Genzyme, and Teva and personal fees from Acorda, Genentech, Sanofi Genzyme, Mallinckrodt, and Teva, and served on speakers' bureaus for EMD Serono, Acorda, Teva, and Genzyme.Tracy Walker, FNP-C, WOCN, MSCN One peer reviewer for the IJMSC has received consulting fees from and participated on speakers' bureaus for Biogen, Novartis, Genentech, Sanofi Genzyme, and EMD Serono. The other peer reviewer has disclosed no relevant financial relationships. The staff at the IJMSC, CMSC, and Delaware Media Group who are in a position to influence content have disclosed no relevant financial relationships. Note: Financial relationships for some authors may have changed in the interval between listing these disclosures and publication of the article. Method of Participation: Release Date: December 1, 2018 Valid for Credit Through: December 1, 2019 In order to receive CME/CNE credit, participants must: Statements of Credit are awarded upon successful completion of the post-test with a passing score of >70% and the evaluation. There is no fee to participate in this activity. Disclosure of Unlabeled Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. CMSC and Delaware Media Group do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of CMSC or Delaware Media Group. Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health-care professionals without first evaluating their patients' conditions, considering possible contraindications or risks, reviewing any applicable manufacturer's product information, and comparing any therapeutic approach with the recommendations of other authorities.

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“…As previously highlighted by Hayes SM et al (2015), the relationship between pwMS and MS clinicians includes complexities that, if not properly addressed in medical education, may negatively impact patient adherence to treatment (Hayes et al, 2015). The shared decision-making approach has been shown to facilitate adherence to MS treatment by taking patient values and preferences in consideration (Ben-Zacharia et al, 2018;Colligan et al, 2017;Eskyte et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…A previous study revealed neurologists and nurses in MS care report sub-optimal levels of knowledge and confidence when screening patients to initiate or switch DMT, assessing safety of new DMTs and monitoring for adverse events (Ng et al, 2015). Further, there is a need for improvement among neurologists and nurses regarding patient communication skills, particularly when sharing treatment decisions and assessing adherence (Hayes et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Challenges in multiple sclerosis care: Results from an international mixed-methods study

Péloquin

Schmierer

Leist³

et al. 2021

Multiple Sclerosis and Related Disorders

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Background: Disease-modifying treatment (DMT) selection for people with multiple sclerosis (MS) is challenging. Neurologists and advanced practice nurses (APNs) in MS care may be facing knowledge and confidence gaps when screening patients to initiate or switch between DMTs, assessing the safety of new DMTs and monitoring for adverse events. Healthcare providers are required to demonstrate enhanced patient communication skills, to share treatment decisions and assess treatment adherence. To better inform educational interventions, there is a need to better understand these challenges and uncover their causalities. We undertook an international study across seven countries to identify challenges for neurologists and APNs that may impact DMT choices and optimum care for people with MS (pwMS). Methods: This mixed methods study involved two concurrent data collection phases, a qualitative phase with semi-structured interviews and a quantitative phase using an online survey. Neurologists (n=333) and APNs (n=135) were recruited from Canada, France, Germany, Italy, Spain, United Kingdom and the United States. All participants had to have a minimum of two years' experience in the care of pwMS and be currently active in clinical practice. Results: A triangulated analysis of qualitative and quantitative data identified multiple challenges. For APNs, these mainly related to diagnosing MS, integrating new agents in their practice, sequential DMT selection, treatment monitoring and providing personalized care. Specifically, two-thirds of APNs reported no or basic knowledge of the 2017 McDonald criteria and over half reported a knowledge gap of new DMTs available (51%) and a skill gap when integrating them into practice (58%). APNs expressed a knowledge gap of treatment sequencing (46%) and a skill gap in making decisions about sequencing (62%). Forty-four percent of APNs reported a gap in their skills of integrating patient's goals into treatment recommendations. For neurologists, the main challenges included managing side effects, aligning care to their patient's personal goals and quality of life (QoL). Specifically, over a third of neurologists reported no or basic knowledge of the characteristics of treatment failure (35%), and 32% reported no or basic skills identifying treatment failure. Skills needed to integrate patient's individual goals into treatment recommendations were reported as none or low by 39% of neurologists. In addition, there were significant differences according to years of practice in the majority (9 out of 14) of confidence items with respect to discussing specific MS-related topics with patients. Significant differences between countries were also identified. Conclusion:The complexity of diagnosing MS and the variety of available DMTs for pwMS lead to uncertainties, even among specialized healthcare professionals. These should be addressed through focused education and training to optimize care for pwMS.

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Identification of clinician challenges in order to drive the development of competency-based education: results from an international needs assessment in multiple sclerosis

Cited by 5 publications

References 22 publications

Adherence to Therapy in Patients with Multiple Sclerosis—Review

Adherence to Therapy in Patients with Multiple Sclerosis—Review

Impact of Shared Decision Making on Disease-Modifying Drug Adherence in Multiple Sclerosis

Challenges in multiple sclerosis care: Results from an international mixed-methods study

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