Emily Casady, BA

She/Her/Hers
Research Assistant II
Neurology
Multiple Sclerosis and Neuroimmunology
Shared Decision Making in Multiple Sclerosis

Principal Investigator: Bonnie I. Glanz, PhD

Authors: Emily C. Casady BA, Bonnie I. Glanz PhD, Brian C. Healy PhD
Lay Abstract

Background: Shared decision-making (SDM) is a model of medical decision-making distinguished by an emphasis on patient knowledge, flow of information between patient and physician, and a shared responsibility among physician and patient regarding final treatment decisions. This may be particularly well-suited for chronic conditions such as multiple sclerosis (MS). We examined SDM in individuals with MS treated at the Brigham MS Center.

Methods: 161 patients completed an anonymous survey that included a standard measure of SDM (SDM-Q-9) as well as questions to assess disease characteristics, risk attitudes and disease expectations.  Summary statistics for each question were calculated, and subjects on high efficacy versus traditional efficacy treatments were compared.  

Results: Patients reported a high level of SDM in their most recent treatment decisions as well as overall satisfaction with their treatment choices.  Although there was no difference between treatment groups in terms of SDM, patients taking high efficacy treatments had significantly higher risk propensity scores and higher disease worsening expectations than patients on traditional efficacy treatments.

Discussion: Our study demonstrated both the high occurrence of SDM among patients at the Brigham MS Center as well as high overall satisfaction with treatment decisions.

Scientific Abstract

Background: Shared decision-making (SDM) is a model of medical decision-making distinguished by an emphasis on patient knowledge, flow of information between patient and physician, and a shared responsibility among physician and patient regarding final treatment decisions. This may be particularly well-suited for chronic conditions such as multiple sclerosis (MS). We examined SDM in individuals with MS treated at the Brigham MS Center.

Methods: 161 patients completed an anonymous survey that included a standard measure of SDM (SDM-Q-9) as well as questions to assess disease characteristics, risk propensity and disease expectations.  Summary statistics for each question were calculated, and subjects on high efficacy versus traditional efficacy treatments were compared.  

Results: Patients reported a high level of SDM in their most recent treatment decisions as well as overall satisfaction with their treatment choices.  Although there was no difference between treatment groups in terms of SDM, patients taking high efficacy treatments had significantly higher risk propensity scores and higher likelihood of disease worsening scores than patients on traditional efficacy treatments.

Discussion: Our study demonstrated both the high occurrence of SDM among patients at the Brigham MS Center as well as high overall satisfaction with treatment decisions.

Clinical Implications
Our study demonstrated that shared decision-making led to a high level of patient satisfaction with treatment decisions amongst MS patients, potentially serving as evidence for implementation of shared decision-making across medical encounters.

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