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Obtaining Patient Priorities in a Multiple Sclerosis Comprehensive Care Center: Beyond Patient-Reported Outcomes.

Deborah M Miller1,2, Brandon Moss1, Susannah Rose2,3

  • 1Mellen Center, Cleveland Clinic, OH, USA.

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|October 16, 2020
PubMed
Summary
This summary is machine-generated.

The most important patient concern (MIPC) question captures unique patient information beyond standard surveys, improving multiple sclerosis (MS) care by addressing individual symptoms and social needs.

Keywords:
clinician–patient relationshipcommunicationlearning health systempatient perspectives/narrativesquantitative methodsrelationships in health care

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Area of Science:

  • Neurology
  • Patient-Reported Outcomes
  • Health Services Research

Background:

  • Multiple Sclerosis (MS) clinics use patient-reported outcome measures (PROMs) and a qualitative 'most important patient concern' (MIPC) question to personalize care.
  • Both methods aim to align clinical encounters with patient values and preferences.

Purpose of the Study:

  • To determine if MIPC responses offer unique insights not captured by PROMs or clinical assessments in MS patients.
  • To evaluate the added value of qualitative patient concerns in comprehensive neurological care.

Main Methods:

  • A cohort of 400 MIPC responders and 400 nonresponders were randomly selected from a database of 2788 MS patients.
  • MIPC responses were categorized and integrated into the Neuro-QoL framework for analysis.
  • Demographic and clinical data were compared between responders with varying numbers of concerns.

Main Results:

  • MIPC responses introduced new categories to the Neuro-QoL Physical and Social domains, including work and cost-of-care.
  • Physical symptoms were the most frequent MIPC (69.9%), with additional concerns related to treatment satisfaction and disease management.
  • Patients reporting more concerns were more likely to be African American, uninsured, and have worse disability.

Conclusions:

  • The MIPC question provides a unique avenue for patients to express specific symptoms, disease management issues, and social concerns.
  • Qualitative MIPC data complements quantitative PROMs, enhancing patient-centered care in multiple sclerosis.
  • Integrating MIPC findings can lead to more tailored and effective patient-provider communication.