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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Sascha Köpke - , University of Lübeck, University Hospital Hamburg Eppendorf, University of Hamburg (Author)
  • Simone Kern - , University Hospital Carl Gustav Carus Dresden (Author)
  • Tjalf Ziemssen - , Department of Neurology, University Hospital Carl Gustav Carus Dresden (Author)
  • Martin Berghoff - , Justus Liebig University Giessen (Author)
  • Ingo Kleiter - , Ruhr University Bochum (Author)
  • Martin Marziniak - , University of Münster (Author)
  • Friedemann Paul - , Max Delbrück Center for Molecular Medicine (MDC), Charité – Universitätsmedizin Berlin (Author)
  • Eik Vettorazzi - , University Hospital Hamburg Eppendorf (Author)
  • Jana Pöttgen - , University Hospital Hamburg Eppendorf (Author)
  • Korbinian Fischer - , University Hospital Hamburg Eppendorf (Author)
  • Jürgen Kasper - , University Hospital Hamburg Eppendorf, University of Hamburg (Author)
  • Christoph Heesen - , University Hospital Hamburg Eppendorf (Author)

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

Original languageEnglish
Pages (from-to)411-418
Number of pages8
JournalJournal of neurology, neurosurgery and psychiatry
Volume85
Issue number4
Publication statusPublished - Apr 2014
Peer-reviewedYes

External IDs

PubMed 24104856

Keywords