Author Of 1 Presentation
P1019 - Discordant patient and provider perceptions of care and shared decision-making practices in multiple sclerosis (ID 1765)
Abstract
Background
Optimal treatment outcomes and quality of life for patients with multiple sclerosis (MS) depend on shared learning, understanding, and decision-making between patients and neurology teams; however, system-, team-, and individual-level barriers pose challenges.
Objectives
As part of a quality improvement initiative, we identified areas of discordance between neurology providers’ (HCPs’) perceptions and patient-reported experiences in shared decision-making (SDM) and MS care.
Methods
From 03/2018–04/2019, we administered surveys to assess challenges, barriers, attitudes, and experiences of neurology teams caring for patients with MS (N=26) and their patients (N=162) at 15 MS clinics.
Results
HCPs believed that patients prioritized slowing disease progression (89% of providers) over other goals. Patients reported reducing relapses (78% of patients) and slowing disease progression (76%) as top treatment goals. Patient ratings and HCP estimates were discordant on factors most important to patients when making decisions about MS treatment: high efficacy (77% patient-reported vs 54% provider-estimated, p = 0.012), safety (65% vs 85%, p = 0.045), side effects (55% vs 85%, p = 0.004), delay of progression (54% vs 35%, p = 0.062), frequency of treatment (10% vs 27%, p = 0.023), oral route of administration (9% vs 8%, p >0.999), and frequency of laboratory testing (7% vs 0%, p = 0.235).
Differences were noted in patients’ and HCPs’ responses on the reasons MS patients do not participate in SDM more often: lack of time for SDM during appointments (49% patient-reported vs 36% HCP-estimated, p = 0.180), preference that the physician make treatment decisions (35% vs 48%, p = 0.147), and patients’ lack of knowledge about MS and available therapies (30% vs 12%, p = 0.048). Notably, 40% of patients reported they did not participate more in SDM because HCPs did not bring up SDM.
Post-program, patients set goals to monitor their MS symptoms closely and share them with their team (57%), take MS treatment as prescribed (47%), and talk with their MS team about treatment options (47%). MS teams committed to engaging their patients more frequently in SDM (65%), talking with their patients about wellness strategies (50%), and conducting more small-group patient education sessions (40%).
Conclusions
These findings reveal discordances between neurology HCP’s perceptions and patient-reported experiences in MS treatment decisions and identify opportunities to address gaps in SDM in MS care.
Presenter Of 1 Presentation
P1019 - Discordant patient and provider perceptions of care and shared decision-making practices in multiple sclerosis (ID 1765)
Abstract
Background
Optimal treatment outcomes and quality of life for patients with multiple sclerosis (MS) depend on shared learning, understanding, and decision-making between patients and neurology teams; however, system-, team-, and individual-level barriers pose challenges.
Objectives
As part of a quality improvement initiative, we identified areas of discordance between neurology providers’ (HCPs’) perceptions and patient-reported experiences in shared decision-making (SDM) and MS care.
Methods
From 03/2018–04/2019, we administered surveys to assess challenges, barriers, attitudes, and experiences of neurology teams caring for patients with MS (N=26) and their patients (N=162) at 15 MS clinics.
Results
HCPs believed that patients prioritized slowing disease progression (89% of providers) over other goals. Patients reported reducing relapses (78% of patients) and slowing disease progression (76%) as top treatment goals. Patient ratings and HCP estimates were discordant on factors most important to patients when making decisions about MS treatment: high efficacy (77% patient-reported vs 54% provider-estimated, p = 0.012), safety (65% vs 85%, p = 0.045), side effects (55% vs 85%, p = 0.004), delay of progression (54% vs 35%, p = 0.062), frequency of treatment (10% vs 27%, p = 0.023), oral route of administration (9% vs 8%, p >0.999), and frequency of laboratory testing (7% vs 0%, p = 0.235).
Differences were noted in patients’ and HCPs’ responses on the reasons MS patients do not participate in SDM more often: lack of time for SDM during appointments (49% patient-reported vs 36% HCP-estimated, p = 0.180), preference that the physician make treatment decisions (35% vs 48%, p = 0.147), and patients’ lack of knowledge about MS and available therapies (30% vs 12%, p = 0.048). Notably, 40% of patients reported they did not participate more in SDM because HCPs did not bring up SDM.
Post-program, patients set goals to monitor their MS symptoms closely and share them with their team (57%), take MS treatment as prescribed (47%), and talk with their MS team about treatment options (47%). MS teams committed to engaging their patients more frequently in SDM (65%), talking with their patients about wellness strategies (50%), and conducting more small-group patient education sessions (40%).
Conclusions
These findings reveal discordances between neurology HCP’s perceptions and patient-reported experiences in MS treatment decisions and identify opportunities to address gaps in SDM in MS care.