Managing psychological stress in the multiple sclerosis medical visit: Patient perspectives and unmet needs

Senders, Angela; Sando, Kelsi; Wahbeh, Helané; Hiller, Amie; Shinto, Lynne

doi:10.1177/1359105314562084

Cited by 24 publications

(19 citation statements)

References 40 publications

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“…Provision of emotional support is crucial to this process and is facilitated through listening to patients and acknowledging their experiences of living with diabetes . Indeed, patients have clearly indicated that they want their experiences of stress acknowledged and validated by professionals . Empathy therefore has an important role to play in communicating successfully with patients.…”

Section: Management Of Distress: Individual Interactionsmentioning

confidence: 99%

“…Diabetes is an ongoing event and life circumstances will change, including perceived ability to cope, which will impact on patients perceived levels of diabetes distress at any one time. In addition, patients report wanting follow‐up and behavioural support for goals achieved, they value some accountability to professionals who are interested in their progress and can help them with problem‐solving regarding their concerns . In fact, retrospective data suggest that supporting people with reassurance at diagnosis, along with clear action plans, resulted in better self‐care 1–5 years after diagnosis, as well as less diabetes distress .…”

Section: Management Of Distress: Individual Interactionsmentioning

confidence: 99%

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Twenty‐five years of diabetes distress research

2019

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The term ‘diabetes distress’ first entered the psychosocial research vernacular in 1995, and refers to ‘the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes’. At first the proponents of the concept were hesitant in advocating that diabetes distress was a major barrier to individuals’ self‐care and management of diabetes. Since then, a burgeoning body of evidence, now including several systematic reviews of intervention studies, suggests that diabetes distress, in both type 1 and type 2 diabetes, across ages and in all countries and cultures where it has been studied, is common and can be a barrier to optimal emotional well‐being, self‐care and management of diabetes. As a consequence, monitoring diabetes distress as part of routine clinical care is part of many national guidelines. The present narrative review summarizes this research and related literature, to postulate the aetiology of diabetes distress, and thus how it may be prevented. The current evidence base for the management of diabetes distress is summarized, and the next steps in the prevention and management of diabetes distress identified.

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Section: Management Of Distress: Individual Interactionsmentioning

confidence: 99%

Section: Management Of Distress: Individual Interactionsmentioning

confidence: 99%

Twenty‐five years of diabetes distress research

2019

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“…Similar findings have been reported in patients with multiple sclerosis (MS) in terms of their choice of disease-modifying therapy [27]. Negative communication experiences have led to some patients with MS perceiving their neurologists as having little interest in their day-to-day ongoing difficulties and stress [28,29].…”

Section: Discussionmentioning

confidence: 60%

Challenges in physician-patient communication for optimal management of systemic sclerosis-associated interstitial lung disease: a discourse analysis

Denton

Laird²,

Moros

et al. 2020

Clin Rheumatol

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Introduction Systemic sclerosis (SSc) is a rare, potentially life-threatening condition. The prognosis is difficult to predict, and treatment is complex. This can be difficult to understand or explain, posing challenges for effective physician-patient communication. Our study assessed communication between physicians and patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD) to identify information gaps and needs. Methods Twenty-three 20-min consultations between physicians (rheumatologists, pulmonologists) and patients (19 real, 4 actors) with diagnosed SSc-ILD across 6 countries were observed and recorded. Interactional sociolinguistic discourse analysis was used to understand the pattern and meaning of communication, whether the needs of both participants were met, and the level of understanding between participants. Results In most consultations, patients were given little opportunity to explain their concerns or ask questions. Physicians used plain language but would revert to medical terminology for complex issues. Patients would also use medical terminology, despite not fully understanding the terms, which led to some physicians mistakenly believing that patients had a better understanding than they did. Differences in cognitive models between physicians and patients were often responsible for misunderstandings. However, during effective consultations, patients were invited to tell their story, and physicians used techniques to check and demonstrate understanding, express empathy and build rapport. Conclusions Communication challenges between physicians and patients limit joint understanding of SSc-ILD and may result in both parties misunderstanding important information and patients being less aware of self-help management approaches. Strategies should be developed with physicians to facilitate effective communication and increase patient understanding and support. Key Points • Physicians and patients have different explanatory models for SSc-ILD. • The differences between the physician-constructed model of SSc-ILD and the personal model patients construct often result in misunderstandings. • Many patients with SSc have learned the medical terminology for their condition, but their often limited understanding may lead to missed opportunities for physicians to provide clear explanations and correct misperceptions. • The style of consultation determines the information patients share and the degree to which they feel supported by, and confident in, their physicians' care.

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“…Since the 1960s, the medical community has been looking for ways to prevent (primary prevention) and treat (secondary prevention) cardiovascular disease through management of cholesterol levels. 1 , 2 In reducing the risk for coronary heart disease, lowering low-density lipoprotein cholesterol (LDL-C), raising high-density lipoprotein cholesterol (HDL-C), and lowering triglycerides appeared to have the potential for reducing both morbidity and mortality. 3 Multiple categories of medications have been developed to manage lipid profiles and reduce the risk of cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy and safety of evolocumab for low-density lipoprotein cholesterol reduction

Henry

Lyon

Ling

2016

VHRM

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Multiple categories of medications have been developed to manage lipid profiles and reduce the risk of cardiovascular events in patients with heart disease. However, currently marketed medications have not solved the problems associated with preventing and treating cardiovascular diseases completely. A substantial population of patients cannot take advantage of statin therapy due to statin intolerance, heart failure, or kidney hemodialysis, suggesting a need for additional effective agents to reduce low-density lipoprotein cholesterol (LDL-C) levels. Proprotein convertase subtilisin/kexin type 9 (PCSK9) was discovered in 2003 and subsequently emerged as a novel target for LDL-C-lowering therapy. Evolocumab is a fully human monoclonal immunoglobulin G2 (IgG2) directed against human PCSK9. By inactivating PCSK9, evolocumab upregulates LDL receptors causing increased catabolism of LDL-C and the consequent reduction of LDL-C levels in blood. Overall, evolocumab has had notable efficacy, with LDL-C reduction ranging from 53% to 75% in monotherapy and combination therapies, and is associated with minor adverse effects. However, studies regarding the ability of evolocumab to reduce mortality as well as long-term safety concerns are limited. The fact that the drug was introduced at a cost much higher than the existing medications and shows a low incremental mortality benefit suggests that many payers will consider evolocumab to have an unfavorable cost–benefit ratio.

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Managing psychological stress in the multiple sclerosis medical visit: Patient perspectives and unmet needs

Cited by 24 publications

References 40 publications

Twenty‐five years of diabetes distress research

Twenty‐five years of diabetes distress research

Challenges in physician-patient communication for optimal management of systemic sclerosis-associated interstitial lung disease: a discourse analysis

Clinical efficacy and safety of evolocumab for low-density lipoprotein cholesterol reduction

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