2020
DOI: 10.1177/2055217320959802
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The impact of the face-to-face consultation on decisional conflict in complex decision-making in multiple sclerosis: A pilot study

Abstract: Background The role of face-to-face consultations in medicine is increasingly being challenged. Disease activity, national guidelines, life goals e.g. pregnancy, multiple therapies and side effects need to be considered on starting disease modifying treatments (DMTs) in people with multiple sclerosis (pwMS). Objectives We studied the impact of a face-to-face consultation on decision making, using decisional conflict (DC) as the primary outcome. Methods Prospective cohort study of 73 pwMS attending clinics who … Show more

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Cited by 5 publications
(5 citation statements)
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References 40 publications
(42 reference statements)
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“…Patient engagement is feasible, effective, and relevant in chronic medical conditions such as hypertension [ 49 ], diabetes [ 50 ], and heart failure [ 51 ]. In PwMS, higher patient activation is associated with improved depressive symptoms, quality of life, self-efficacy, and fatigue [ 46 , 52 , 53 ] as well as greater confidence in selecting disease modifying therapies in partnership with their MS healthcare providers [ 54 ]. A focus on patient engagement is a relatively novel topic with PwMS, but there was consensus among the Multiple Sclerosis in the 21 st Century Steering Committee (an international working group of both MS experts and patient group representatives) that integration of PROMs into clinical practice may be a means to facilitate patient engagement [ 22 ].…”
Section: Discussionmentioning
confidence: 99%
“…Patient engagement is feasible, effective, and relevant in chronic medical conditions such as hypertension [ 49 ], diabetes [ 50 ], and heart failure [ 51 ]. In PwMS, higher patient activation is associated with improved depressive symptoms, quality of life, self-efficacy, and fatigue [ 46 , 52 , 53 ] as well as greater confidence in selecting disease modifying therapies in partnership with their MS healthcare providers [ 54 ]. A focus on patient engagement is a relatively novel topic with PwMS, but there was consensus among the Multiple Sclerosis in the 21 st Century Steering Committee (an international working group of both MS experts and patient group representatives) that integration of PROMs into clinical practice may be a means to facilitate patient engagement [ 22 ].…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, they do not strictly measure knowledge but consider it a subconstruct of the ''activation.'' In addition, both are generic instruments, not specifically targeted at people with MS, although they have been used in studies in the area of MS [46,47]. However, researchers and clinicians should consider other instruments to perform more specific measures of MS-related knowledge.…”
Section: Discussionmentioning
confidence: 99%
“…treatments are available for relapsing-remitting MS (RRMS) at different doses and with varying features. 3 Therefore, patients with RRMS may experience decisional conflict at the time of treatment choice. 4 Shared decision making (SDM), a decision-making process shared by patients and their healthcare providers, aims to help patients and clinicians reach a treatment decision considering patients' values.…”
mentioning
confidence: 99%
“…4 Shared decision making (SDM), a decision-making process shared by patients and their healthcare providers, aims to help patients and clinicians reach a treatment decision considering patients' values. 3,5 Nurse professionals lead the SDM process by providing patients with support and information during faceto-face clinical encounters. In the Spanish setting, neurologists are legally responsible for prescriptions and therefore participate in the SDM process, making the final treatment decision and prescription.…”
mentioning
confidence: 99%
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