Article

OBJECTIVE: To investigate the effectiveness of a multi-component evidence-based
education programme on disease modifying therapies in multiple sclerosis. DESIGN:
Controlled trial with two consecutive patient cohorts and a gap of two months
between cohorts. SETTING: Three neurological rehabilitation centres. SUBJECTS:
Patients with multiple sclerosis within rehabilitation. INTERVENTIONS: Control
group (CG) participants were recruited and received standard information. Two
months later, intervention group (IG) participants were recruited and received a
six-hour nurse-led interactive group education programme consisting of two parts
and a comprehensive information brochure. MAIN MEASURES: Primary endpoint was
"informed choice", comprising of adequate risk knowledge in combination with
congruency between attitude towards immunotherapy and actual immunotherapy
uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and
depression, self-efficacy, and fatigue. RESULTS: A total of 156 patients were
included (IG=75, CG=81). The intervention led to significantly more participants
with informed choice (IG: 47% vs. CG: 23%, P=0.004). The rate of persons with
adequate risk knowledge was significantly higher in the IG two weeks after the
intervention (IG: 54% vs. CG: 31%, P=0.007), but not after six months (IG: 48%
vs. CG: 31%, P=0.058). No significant differences were shown for positive
attitude towards disease modifying therapy (IG: 62% vs. CG: 71%, P=0.29) and for
disease modifying therapy status after six months (IG: 61.5% vs CG: 68.6%,
P=0.39). Also no differences were found for autonomy preferences and decisional
conflict after six months. CONCLUSION: Delivering evidence-based information on
multiple sclerosis disease modifying therapies within a rehabilitation setting
led to a marked increase of informed choices.

Langue : ANGLAIS