Eskyte, I, Manzano, A orcid.org/0000-0001-6277-3752, Pepper, G et al. (8 more authors) (2019) Understanding treatment decisions from the perspective of people with relapsing remitting multiple Sclerosis: A critical interpretive synthesis. Multiple Sclerosis and Related Disorders, 27. pp. 370-377. ISSN 2211-0348
Abstract
Background: Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system that mainly affects young adults. While there is no cure for MS, disease modifying treatments (DMTs) reduce the relapse rate and partial accrual of disability. More effective DMTs may have higher risks including life-threatening infections or secondary autoimmunity. The complexity and novelty of available treatments cause challenges for clinicians when prescribing treatments and for people with MS (PwMS) when deciding what trade-offs they are willing and ready to make.
Objective: To explore the experience of people with relapsing remitting MS (PwRRMS) and their perspectives in choosing treatments.
Methods: Critical interpretive synthesis was employed to review and synthesis the published literature. Eighty-three publications were selected in a multi-step systematic process.
Results: Findings are presented in four interrelated areas: the influence of the clinical evidence-base in decision making; the meaning of DMT efficacy for PwRRMS; the influence of models of decision-making and information acquisition practices in PwRRMS; and the importance of psychosocial dimensions in DMT decision making. Synthesis of the findings revealed that alongside medical and individual reasoning, contextual circumstances play an important role in making treatment decisions.
Conclusion: This review identifies and explains the importance of diverse contextual circumstances (clinical, social, psychological) that are important for PwRRMS when making treatment decisions. The findings demonstrate the importance of eliciting, understanding and addressing such contextual factors.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018 Published by Elsevier B.V. This is an author produced version of a paper published in Multiple Sclerosis and Related Disorders. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Multiple sclerosis; Relapsing-remitting multiple sclerosis; Disease-modifying treatments; Decision-making; Person-focused care; Decision-support techniques |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Education, Social Sciences and Law (Leeds) > School of Law (Leeds) The University of Leeds > Faculty of Education, Social Sciences and Law (Leeds) > School of Sociology and Social Policy (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Applied Health and Clinical Translation (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds) |
Funding Information: | Funder Grant number Multiple Sclerosis Society Award Ref: 30 |
Depositing User: | Symplectic Publications |
Date Deposited: | 26 Nov 2018 09:54 |
Last Modified: | 17 Nov 2019 01:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.msard.2018.11.016 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:139134 |
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