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Nurse-led immunotreatment DEcision Coaching In people with Multiple Sclerosis (DECIMS) - A cluster- randomised
1Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
Patient Education and Counseling
|May 10, 2024
Summary
Nurse-led decision coaching may improve informed decision-making for multiple sclerosis (MS) patients considering immunotherapy. This approach, involving trained nurses, showed potential benefits over standard information provision alone.
Area of Science:
- Neurology
- Health Services Research
- Patient Decision Making
Background:
- Multiple sclerosis (MS) treatment decisions, particularly regarding immunotherapy, are complex.
- Effective decision support is crucial for patients to make informed choices aligned with their values.
- Task redistribution to nurses can enhance patient support in complex treatment scenarios.
Purpose of the Study:
- To evaluate a nurse-led decision coaching program designed to support immunotherapy decision-making in individuals with MS.
- To assess the impact of decision coaching on informed choice among MS patients facing treatment decisions.
Main Methods:
- A cluster-randomised controlled trial with a mixed-methods process evaluation was conducted.
- Participants with clinically isolated syndrome or relapsing-remitting MS were recruited across German clusters.
- The intervention involved nurse-led decision coaching sessions and an online information platform; controls received only the platform.
Main Results:
- The trial was terminated early due to insufficient recruitment, with 125 participants enrolled.
- A non-significant trend favored the decision coaching group for informed choice (OR 1.64, 95% CI 0.49-5.53).
- Twelve nurses were trained, and eight clusters participated in the intervention.
Conclusions:
- Nurse-led decision coaching shows potential in facilitating informed decision-making for MS patients compared to information provision alone.
- Implementation challenges and barriers need to be addressed for successful integration of decision coaching into clinical practice.
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