Manzano, A orcid.org/0000-0001-6277-3752, Eskyte, I orcid.org/0000-0001-9486-0033, Ford, HL et al. (8 more authors) (2020) Impact of communication on first treatment decisions in people with relapsing-remitting multiple sclerosis. Patient Education and Counseling, 103 (12). pp. 2540-2547. ISSN 0738-3991
Abstract
Objective: Disease-Modifying Treatments (DMTs) have contributed to a new clinical landscape for people with relapsing-remitting multiple sclerosis (pwRRMS). A challenge for services is how to support DMT decisions with changing clinical evidence, and differing treatment goals. This article investigates how pwRRMS weigh up the pros and cons of DMTs by examining how communication at the point of diagnosis is related to DMT decisions.
Methods: 30 semi-structured interviews with pwRRMS in England were conducted using a theoretical purposive sampling strategy and analysed using the thematic approach to answer: How does communication about RRMS during diagnosis influence decisions about when and which DMT to choose?
Results: Three meta-themes were identified: a) communication context; b) delayed communication and hope for people with “non-active” RRMS at diagnosis; c) people with “active” RRMS at diagnosis: Conflated, generic, selective and simplified information
Conclusion: At the time of diagnosis, patient–physician interactions are characterised by emotions and information complexity. Clinical, social and psychological DMT filtering mechanisms are activated during first decisions. Personalised evidence is needed to make informed decisions.
Practice implications: Patient decision aids should consider first and consecutive decisions and should not encourage a false sense of large choices that could add to decision anxiety.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2020 Elsevier B.V. All rights reserved. This is an author produced version of an article published in Patient Education and Counseling. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Multiple sclerosis; Relapsing-remitting multiple sclerosis; Disease-modifying therapy; Treatment decision-making; Diagnosis communication; Qualitative research; Shared decision-making; Patient perspective |
Dates: |
|
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: | 14 May 2020 11:06 |
Last Modified: | 24 Feb 2025 10:52 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.pec.2020.05.014 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:160719 |
Downloads
Filename: Manuscript-RRMS-Decisions- Accepted-Manzano et al.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table1.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table2.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table3.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table4.pdf
Licence: CC-BY-NC-ND 4.0
Filename: Table5.pdf
Licence: CC-BY-NC-ND 4.0