Article

Determining whether persons with multiple sclerosis (MS) receive appropriate,
comprehensive healthcare requires tools for measuring quality. The objective of
this study was to develop quality indicators for the care of persons with MS. We
used a modified version of the RAND/UCLA Appropriateness Method in a two-stage
process to identify relevant MS care domains and to assess the validity of
indicators within high-ranking care domains. Based on a literature review,
interviews with persons with MS, and discussions with MS providers, 25 MS symptom
domains and 14 general health domains of MS care were identified. A
multidisciplinary panel of 15 stakeholders of MS care, including 4 persons with
MS, rated these 39 domains in a two-round modified Delphi process. The research
team performed an expanded literature review for 26 highly ranked domains to
draft 86 MS care indicators. Through another two-round modified Delphi process, a
second panel of 18 stakeholders rated these indicators using a nine-point
response scale. Indicators with a median rating in the highest tertile were
considered valid. Among the most highly rated MS care domains were
appropriateness and timeliness of the diagnostic work-up, bladder dysfunction,
cognition dysfunction, depression, disease-modifying agent usage, fatigue,
integration of care, and spasticity. Of the 86 preliminary indicators, 76 were
rated highly enough to meet predetermined thresholds for validity. Following a
widely accepted methodology, we developed a comprehensive set of quality
indicators for MS care that can be used to assess quality of care and guide the
design of interventions to improve care among persons with MS.

Langue : ANGLAIS

Tiré à part : OUI