Informed shared decision making about immunotherapy for patients with multiple sclerosis (ISDIMS): a randomized...

Area of Science:

• Neurology
• Medical Decision Making
• Health Communication

Background:

• Multiple Sclerosis (MS) immunotherapy involves complex treatment decisions.
• Patient engagement in decision-making is crucial for treatment adherence and satisfaction.

Purpose of the Study:

• To evaluate the impact of an evidence-based patient decision aid (DA) on multiple sclerosis (MS) immunotherapy choices.
• To assess the effect of a DA on patient roles and decision-making processes during physician consultations.

Main Methods:

• A randomized controlled trial involving 297 MS patients considering immunotherapy.
• Intervention group received a DA; control group received standard information.
• Primary outcome: match between patient's preferred and actual roles; secondary outcome: treatment choice.

Main Results:

• No significant difference in preference-role match between the decision aid and standard information groups (49% vs 51%).
• No difference in immunotherapy treatment choices between the groups.
• Patients receiving the decision aid reported temporarily increased critical evaluation of immunotherapy and found the information more helpful.

Conclusions:

• The evidence-based decision aid did not alter patient roles in consultations or immunotherapy choices.
• Intensified information processing did not lead to significant changes in decision outcomes.
• Balanced patient information alone may be insufficient to modify complex medical decision-making processes.