Evidence-based patient information programme in early multiple sclerosis: A randomised controlled trial

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Sascha Köpke - , Universität zu Lübeck, Universitätsklinikum Hamburg-Eppendorf (UKE), Universität Hamburg (Autor:in)
  • Simone Kern - , Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Tjalf Ziemssen - , Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Martin Berghoff - , Justus Liebig University Giessen (Autor:in)
  • Ingo Kleiter - , Ruhr-Universität Bochum (Autor:in)
  • Martin Marziniak - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Friedemann Paul - , Max-Delbrück-Centrum für Molekulare Medizin (MDC), Charité – Universitätsmedizin Berlin (Autor:in)
  • Eik Vettorazzi - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Jana Pöttgen - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Korbinian Fischer - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Jürgen Kasper - , Universitätsklinikum Hamburg-Eppendorf (UKE), Universität Hamburg (Autor:in)
  • Christoph Heesen - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)

Abstract

Objective: To evaluate the efficacy of an evidence-based patient information programme aiming to increase informed choice in patients with early multiple sclerosis (MS). Background: Patients with early MS face a number of uncertainties concerning diagnosis, prognosis and effectiveness of immunotherapy. Prior studies suggest that evidence-based patient information combined with group education can promote informed choice in MS patients. Methods: A 12-month, six-centre, double-blind randomised controlled clinical trial with 192 patients with a diagnosis of confirmed relapsing-remitting MS or clinical isolated syndrome in Germany. A 4-h interactive evidence-based educational programme was compared with a 4-h MS-specific stress management programme. The primary endpoint was informed choice after 6 months comprising risk knowledge and congruency between attitude towards immunotherapy and actual immunotherapy uptake. Secondary endpoints included autonomy preference, decision autonomy, decisional conflict and satisfaction, anxiety and depression, and number of immunotherapies. Results: For the primary endpoint, a significant difference was shown with 50 of 85 (59%) participants in the intervention group achieving informed choice after 6 months compared with 18 of 89 (20%) in the control group (OR 0.2 (95% CI 0.1 to 0.4), p<0.001). Four weeks after the intervention, more participants in the intervention group showed good risk knowledge (difference between groups 39% (95% CI 26% to 53%), p<0.001). There were no signifi cant differences between groups for attitude towards immunotherapy and for immunotherapy uptake. There were trends towards increased autonomy preference after the intervention and increased adherence to immunotherapies in the intervention group. Conclusions: The intervention signi ficantly increased informed choice and relevant risk knowledge without negative side effects.

Details

OriginalspracheEnglisch
Seiten (von - bis)411-418
Seitenumfang8
FachzeitschriftJournal of neurology, neurosurgery and psychiatry
Jahrgang85
Ausgabenummer4
PublikationsstatusVeröffentlicht - Apr. 2014
Peer-Review-StatusJa

Externe IDs

PubMed 24104856