“…These included bladder symptoms, 44 pain, 58 fatigue, 34,51,60,61 spasticity, 62 speech problems, 63 balance disturbances, 43 and cognitive and mood changes. 64 This unpredictability caused worry, 43,44,53 made it difficult to plan, 38,43,44,53,58,60 and disrupted valued roles and activities, 22,38,43,44,53,58,60,62 and everyday routines. 22,43,44,62 Lack of certainty about treatment effectiveness, including impact on clinical course, made it difficult to make decisions about which treatments to choose, especially considering potential significant side-effects and impact on quality of life.…”