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Patient needs and preferences in relapsing-remitting multiple sclerosis: A systematic review
L A Visser1, C Louapre2, C A Uyl-de Groot1
1Erasmus School of Health Policy & Management, Erasmus University Rotterdam. Bayle Building, Burgermeester Oudlaan 50. 3062 PA, Rotterdam, the Netherlands.
Multiple Sclerosis and Related Disorders
|January 12, 2020
Summary
Understanding patient needs is crucial for multiple sclerosis (MS) treatment decisions. Patient preferences for disease-modifying treatments (DMTs) in clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS) impact adherence and outcomes.
Area of Science:
- Neurology
- Patient-Centered Care
- Pharmacoeconomics
Background:
- Multiple sclerosis (MS) treatment landscape is complex with numerous approved therapies.
- Patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS) face challenges in selecting optimal disease-modifying treatments (DMTs).
- A gap exists in understanding patient needs and preferences at various stages of the treatment journey.
Purpose of the Study:
- To systematically review and synthesize existing literature on the needs and preferences of CIS and RRMS patients during treatment decision-making.
- To identify key factors influencing patient choices regarding first-line DMT initiation, adherence, discontinuation, and switching.
Main Methods:
- Systematic literature search across major databases (Embase, Medline, PsychINFO, Web of Science, Google Scholar).
- Eligibility criteria focused on adult CIS/RRMS patients and reported needs/preferences for first-line DMT decisions.
- Publications categorized by decision point: initiation (D1), adherence/discontinuation (D2a/D2b), and switching (D3), including stated preference studies.
Main Results:
- Twenty-four articles met inclusion criteria, covering various decision points.
- Social support is a key factor during initial DMT decision-making (D1).
- Common reasons for non-adherence or switching include forgetfulness, side effects, and administration-related issues.
- Key DMT attributes influencing preferences are efficacy, administration method/frequency, and side-effect profile.
Conclusions:
- Understanding patient needs and preferences for DMT attributes and non-treatment factors is vital for improving treatment decisions and reducing non-adherence in CIS/RRMS.
- Further research is needed to elucidate patient preferences specifically at the point of treatment initiation.
- Future preference studies should prioritize attributes identified from the patient's perspective to enhance clinical relevance.
