Informed shared decision making about immunotherapy for patients with multiple sclerosis (ISDIMS): a randomized controlled trial

Eur J Neurol. 2008 Dec;15(12):1345-52. doi: 10.1111/j.1468-1331.2008.02313.x.

Abstract

Background and purpose: To evaluate the effects of an evidence-based patient decision aid (DA) on multiple sclerosis (MS) immunotherapy.

Methods: Two hundred and ninety-seven MS patients who were considering or reconsidering immunotherapy participated in a randomized community-based controlled trial in Germany. An intervention group (IG) received the DA and a control group (CG) received standard information. Primary outcome measure was the match between the patient's preferred and actual roles during consultation with the physician. Secondary end-point was treatment choice. The course of the decision-making process and patients; evaluation of the decision were also evaluated. Data were collected at baseline, after receiving the information, after consultation with the physician and 6 months after baseline.

Results: The percentage of preference matches did not differ between groups (IG 49%, CG 51%, P = 0.71). There were no differences in immunotherapy choices between groups. IG patients temporarily became more critical of immunotherapy and rated the information as significantly more helpful.

Conclusions: Although the intervention led to intensified processing of the information it affected neither the roles adopted in physician-patient encounters nor the immunotherapy choices made. Providing patients with balanced information may not be sufficient to alter the decision-making process.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Data Interpretation, Statistical
  • Decision Support Techniques
  • Female
  • Germany
  • Humans
  • Immunotherapy / methods*
  • Immunotherapy / psychology
  • Informed Consent
  • Male
  • Middle Aged
  • Multiple Sclerosis / therapy*
  • Outcome Assessment, Health Care / methods
  • Patient Education as Topic
  • Patient Participation / methods*
  • Patient Satisfaction
  • Physician-Patient Relations*