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Implementing Shared Decision-Making for Multiple Sclerosis: The MS-SUPPORT Tool.

Nananda F Col1, Andrew J Solomon2, Enrique Alvarez3

  • 1Shared Decision Making Resources, Georgetown, ME.

Multiple Sclerosis and Related Disorders
|November 6, 2023
PubMed
Summary
This summary is machine-generated.

The MS-SUPPORT tool improved adherence and mental health for multiple sclerosis (MS) patients by facilitating shared decision-making (SDM) regarding disease-modifying therapies (DMTs). This patient-centered approach enhances treatment understanding and adherence.

Keywords:
Decision Support Systems, ClinicalDecision making, sharedMedication AdherenceMultiple SclerosisMultiple Sclerosis, Relapsing-Remitting / drug therapyPatient preferencesPsychological Well-BeingRandomized Controlled Trial

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Area of Science:

  • Neurology
  • Health Services Research
  • Patient-Centered Care

Background:

  • Multiple sclerosis (MS) treatment decisions are complex, necessitating improved shared decision-making (SDM) processes.
  • Patient-centered tools are needed to support people with MS (pwMS) in choosing disease-modifying therapies (DMTs).
  • The MS-SUPPORT tool was developed to facilitate SDM for pwMS.

Purpose of the Study:

  • To evaluate the feasibility and impact of the MS-SUPPORT tool on DMT decisions.
  • To assess the effects of MS-SUPPORT on SDM processes and quality-of-life in pwMS.
  • To compare the MS-SUPPORT intervention against usual care in a multisite randomized controlled trial.

Main Methods:

  • A 12-month randomized controlled trial compared the MS-SUPPORT intervention to usual care.
  • Participants included English-speaking adults with relapsing MS and their clinicians.
  • MS-SUPPORT is an online, interactive decision aid co-created with pwMS, providing tailored information and generating personalized summaries for clinician review.

Main Results:

  • MS-SUPPORT was highly recommended by patients, improving their understanding of options and DMT adherence.
  • The intervention group showed a trend towards higher DMT utilization and significantly better adherence to daily-dosed DMTs.
  • Patients using MS-SUPPORT reported fewer days of poor mental health compared to the control group.

Conclusions:

  • MS-SUPPORT is a feasible and well-endorsed tool for enhancing SDM in MS care.
  • The tool positively impacts DMT initiation, adherence, and patient mental health.
  • Further research should explore real-world implementation and reinforcement strategies for MS-SUPPORT.