A Novel Tool to Improve Shared Decision Making and Adherence in Multiple Sclerosis: Development and Preliminary...

Area of Science:

• Neurology
• Health Services Research
• Patient-Centered Care

Background:

• Most multiple sclerosis (MS) patients desire involvement in decisions regarding disease-modifying therapies (DMTs).
• Existing methods often fail to overcome barriers to patient participation in treatment decisions.
• Novel approaches are required to enhance shared decision-making (SDM) in MS care.

Purpose of the Study:

• To develop a patient-centered SDM tool for MS DMTs.
• To evaluate patient and provider feedback on the developed tool.
• To identify challenges and inform future clinical trials for SDM in MS.

Main Methods:

• A patient-centered design process, informed by image theory, was used to create the MS-SUPPORT SDM tool.
• Development involved semistructured interviews and iterative alpha and beta testing with MS patients and healthcare providers.
• Beta testing assessed tool dissemination, clinical integration, decision-making processes, communication, and adherence.

Main Results:

• The MS-SUPPORT tool facilitates patient self-assessment, goal identification, and preference clarification, providing tailored feedback.
• A personal summary report generated by the tool aids patient-provider communication, though only 60% of testers shared it.
• Beta testing indicated high ratings for patient-provider communication, patient preparation, and adherence, with feasible dissemination strategies.

Conclusions:

• The developed MS-SUPPORT tool is patient-centered and may enhance patient involvement in MS treatment decisions.
• The tool can help providers understand patient preferences and potentially improve treatment adherence.
• Real-world beta testing was crucial for refining the tool and informing the design of future studies.