Combination treatment of people with multiple sclerosis based on collaboration between conventional healthcare providers and alternative practitioners--patient perspectives on outcomes.

The use of alternative and complementary medicine (CAM) is prevalent among People with Multiple Sclerosis (PwMS) in Denmark as well as in other Western countries. Many PwMS combine conventional treatments and CAM; however there is little research-based knowledge about the outcomes that PwMS achieve from combined treatments. The purpose of this article is to describe which outcomes PwMS have experienced from combination treatment based on collaboration between conventional healthcare providers and CAM practitioners. A second purpose is to identify and study aspects of the courses of treatment that have generally characterized the achieved outcomes. During the course of their treatment, 59 PwMS participated in semi-structured individual or group interviews. The analyses show that the participants' experienced outcomes can be classified in four ways 1) short-term positive outcomes; 2) long-term positive outcomes in specific areas; 3) long-term positive outcomes on the patient's overall life situation; 4) no and/or negative outcomes. The analyses also show that two aspects of the courses of treatment have generally characterized the outcomes achieved: a) participants' perception of the patient's role; b) participants' perception of treatment function. Outcomes are shown to differ for different PwMS, and results indicate that the combined interventions have played a role in a dynamic and process-oriented interaction with the entire life situation of the individual patient. The results described in the article further suggest that physical as well as cognitive learning constitutes an important element in understanding the dynamics of complex courses of treatment.