Motherhood choice in multiple sclerosis (MoMS) - Pilot trial of web-based decision support

Area of Science:

• Neurology
• Reproductive Health
• Healthcare Interventions

Background:

• Women with multiple sclerosis (wwMS) often experience uncertainty regarding motherhood.
• A patient decision aid (PtDA) and a nurse-led decision coaching (DC) intervention were developed to support this choice.
• The DC intervention integrates the PtDA, a decision guide, and coaching.

Purpose of the Study:

• To test the feasibility of a PtDA and a DC intervention for women with multiple sclerosis (wwMS) considering motherhood.
• To explore the impact of these interventions on decisional conflict using a randomized pilot trial.

Main Methods:

• A randomized pilot trial was conducted in Germany with 35 women with MS (18-45 years old) who had not decided about motherhood.
• Interventions included a patient decision aid (PtDA) and a nurse-led decision coaching (DC) program.
• Feasibility, decisional conflict (Decisional Conflict Scale), knowledge, and worries were assessed via questionnaires and interviews.

Main Results:

• The nurse-led decision coaching (DC) group showed a greater reduction in decisional conflict compared to the patient decision aid (PtDA) group (median DCS scores: 49 to 15 for DC vs. 54 to 31 for PtDA).
• Both interventions were perceived as helpful for decision-making by participants and nurses.
• Qualitative data suggested higher satisfaction levels in the DC group.

Conclusions:

• Both the PtDA and the DC intervention are useful for women with multiple sclerosis (wwMS) facing motherhood decisions.
• The nurse-led decision coaching (DC) program appears to be a more effective approach for supporting decision-making in this population.