Jorge Maurino1, Javier Sotoca2, Ángel P Sempere3, Luis Brieva4, Carlos López de Silanes5, Ana B Caminero6, María Terzaghi7, Julia Gracia-Gil8, Gustavo Saposnik7,9,10. 1. Medical Department, Roche Farma, Ribera del Loira, 50, 28042, Madrid, Spain. jorge.maurino@roche.com. 2. Department of Neurology, Hospital Universitari Mútua de Terrassa, Terrassa, Spain. 3. Department of Neurology, Hospital General Universitario de Alicante, Alicante, Spain. 4. Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain. 5. Department of Neurology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Spain. 6. Department of Neurology, Complejo Asistencial de Ávila, Ávila, Spain. 7. Decision Neuroscience Unit, Li Ka Shing Institute, University of Toronto, Toronto, Canada. 8. Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain. 9. Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Canada. 10. Laboratory for Social and Neural System Research, Department of Economics, University of Zurich, Zurich, Switzerland.
Abstract
BACKGROUND: Risk attitude is defined as the willingness to tolerate risk to achieve a greater expected return. Limited information is available on how relapsing-remitting multiple sclerosis people's perceptions about disease trajectory and risk attitude may influence treatment choices. METHODS: A non-interventional study applying principles of behavioral economics was conducted to assess willingness to receive unwarranted high-efficacy disease-modifying therapy (DMT) according to best-practice guidelines. People with relapsing-remitting multiple sclerosis (PwRRMS) according to 2010 McDonald criteria completed a survey on symptom severity, risk preferences, and management of simulated case scenarios mimicking the current treatment landscape. PwRRMS's choice for high-efficacy agents was established as the participant's selection of monoclonal antibodies for case scenarios with at least 2 years of clinical and radiological stability. RESULTS: A total of 211 PwRRMS were studied (mean age 39.1 ± 9.5 years, 70.1% female, mean Expanded Disability Status Scale score 1.8 ± 1.1). Almost 50% (n = 96) opted for a high-efficacy DMT despite the lack of evidence of disease activity. Younger age and risk-seeking behavior were associated with an increased likelihood of selecting unwarranted high-efficacy DMT [odds ratio (OR) 2.00, 95% confidence interval (CI) 1.02-3.93, p = 0.043, and OR 2.17, 95% CI 1.09-4.30, p = 0.027, respectively]. Clinical characteristics or subjective perception of symptom severity had no influence on participants' treatment choices. CONCLUSION: Identifying PwRRMS with risk-seeking behavior would be crucial to implementing specific educational strategies to manage information on disease prognosis, treatment expectations, and safety risk knowledge.
BACKGROUND: Risk attitude is defined as the willingness to tolerate risk to achieve a greater expected return. Limited information is available on how relapsing-remitting multiple sclerosispeople's perceptions about disease trajectory and risk attitude may influence treatment choices. METHODS: A non-interventional study applying principles of behavioral economics was conducted to assess willingness to receive unwarranted high-efficacy disease-modifying therapy (DMT) according to best-practice guidelines. People with relapsing-remitting multiple sclerosis (PwRRMS) according to 2010 McDonald criteria completed a survey on symptom severity, risk preferences, and management of simulated case scenarios mimicking the current treatment landscape. PwRRMS's choice for high-efficacy agents was established as the participant's selection of monoclonal antibodies for case scenarios with at least 2 years of clinical and radiological stability. RESULTS: A total of 211 PwRRMS were studied (mean age 39.1 ± 9.5 years, 70.1% female, mean Expanded Disability Status Scale score 1.8 ± 1.1). Almost 50% (n = 96) opted for a high-efficacy DMT despite the lack of evidence of disease activity. Younger age and risk-seeking behavior were associated with an increased likelihood of selecting unwarranted high-efficacy DMT [odds ratio (OR) 2.00, 95% confidence interval (CI) 1.02-3.93, p = 0.043, and OR 2.17, 95% CI 1.09-4.30, p = 0.027, respectively]. Clinical characteristics or subjective perception of symptom severity had no influence on participants' treatment choices. CONCLUSION: Identifying PwRRMS with risk-seeking behavior would be crucial to implementing specific educational strategies to manage information on disease prognosis, treatment expectations, and safety risk knowledge.
Authors: Edward J D Webb; David Meads; Ieva Eskytė; Helen L Ford; Hilary L Bekker; Jeremy Chataway; George Pepper; Joachim Marti; Yasmina Okan; Sue H Pavitt; Klaus Schmierer; Ana Manzano Journal: Patient Date: 2020-10 Impact factor: 3.883
Authors: Gustavo Saposnik; Angel P Sempere; Daniel Prefasi; Daniel Selchen; Christian C Ruff; Jorge Maurino; Philippe N Tobler Journal: Front Neurol Date: 2017-03-01 Impact factor: 4.003
Authors: Jane Desborough; Crystal Brunoro; Anne Parkinson; Katrina Chisholm; Mark Elisha; Janet Drew; Vanessa Fanning; Christian Lueck; Anne Bruestle; Matthew Cook; Hanna Suominen; Antonio Tricoli; Adam Henschke; Christine Phillips Journal: Health Expect Date: 2020-06-24 Impact factor: 3.377