BACKGROUND: Patient autonomy is a bioethical principle that was strengthened in the revised Declaration of Geneva. Shared decision making (SDM) is particularly relevant in the management of multiple sclerosis (MS) because many preference-sensitive decisions have to be made during the disease course. We aimed to summarize the available evidence on SDM in the MS field and to inform future research and practice. METHODS: We performed a scoping review by searching MEDLINE (past 5 years). Studies were included if they reported primary/secondary research and focused on SDM related to people with MS. Data were grouped into topics, with results presented in narrative form. RESULTS: From 865 references, we included 55 studies conducted mostly in Europe. Half of the studies were observational, followed by qualitative (20%), mixed-methods (17%), randomized controlled trials (RCTs, 5%), quasi-experimental (5%), and reviews (4%). Most studies addressed people with relapsing-remitting MS (85%); the remaining addressed health care professionals, patients' significant others, or a combination. We identified five main topics: decisions on disease-modifying drugs, decisions on chronic cerebrospinal venous insufficiency treatment, information provision and patient education, health literacy, and risk knowledge. CONCLUSIONS: The high proportion of included studies on SDM in MS in Europe suggests an earlier adoption of these concepts in this area. Decisions on disease-modifying drugs was the prevalent topic. Only 5% of studies were RCTs, indicating that more research is needed to study the effectiveness of SDM interventions. Studies addressing people with primary and secondary progressive MS are also needed.
BACKGROUND: Patient autonomy is a bioethical principle that was strengthened in the revised Declaration of Geneva. Shared decision making (SDM) is particularly relevant in the management of multiple sclerosis (MS) because many preference-sensitive decisions have to be made during the disease course. We aimed to summarize the available evidence on SDM in the MS field and to inform future research and practice. METHODS: We performed a scoping review by searching MEDLINE (past 5 years). Studies were included if they reported primary/secondary research and focused on SDM related to people with MS. Data were grouped into topics, with results presented in narrative form. RESULTS: From 865 references, we included 55 studies conducted mostly in Europe. Half of the studies were observational, followed by qualitative (20%), mixed-methods (17%), randomized controlled trials (RCTs, 5%), quasi-experimental (5%), and reviews (4%). Most studies addressed people with relapsing-remitting MS (85%); the remaining addressed health care professionals, patients' significant others, or a combination. We identified five main topics: decisions on disease-modifying drugs, decisions on chronic cerebrospinal venous insufficiency treatment, information provision and patient education, health literacy, and risk knowledge. CONCLUSIONS: The high proportion of included studies on SDM in MS in Europe suggests an earlier adoption of these concepts in this area. Decisions on disease-modifying drugs was the prevalent topic. Only 5% of studies were RCTs, indicating that more research is needed to study the effectiveness of SDM interventions. Studies addressing people with primary and secondary progressive MS are also needed.
Authors: A Solari; V Martinelli; M Trojano; A Lugaresi; F Granella; A Giordano; M Messmer Uccelli; R D'Alessandro; E Pucci; P Confalonieri; C Borreani Journal: Mult Scler Date: 2010-09-21 Impact factor: 6.312
Authors: Nananda F Col; Andrew J Solomon; Vicky Springmann; Carolina Ionete; Enrique Alvarez; Brenda Tierman; Christen Kutz; Idanis Berrios Morales; Carolyn Griffin; Long H Ngo; David E Jones; Glenn Phillips; Ashli Hopson; Lori Pbert Journal: Int J MS Care Date: 2018 Nov-Dec
Authors: P Zamboni; R Galeotti; E Menegatti; A M Malagoni; G Tacconi; S Dall'Ara; I Bartolomei; F Salvi Journal: J Neurol Neurosurg Psychiatry Date: 2008-12-05 Impact factor: 10.154
Authors: Massimiliano Mirabella; Pietro Annovazzi; Wallace Brownlee; Jeffrey A Cohen; Christoph Kleinschnitz; Christian Wolf Journal: Front Neurol Date: 2022-04-15 Impact factor: 4.086