Successful Management of Multiple Sclerosis Starts with Shared Decision-Making

Shared decision-making between patients and physicians is crucial for the effective treatment of multiple sclerosis (MS), according to a report published in Practical Neurology.

The process involves patients and clinicians working together to make decisions regarding testing, treatments, and care plans. Shared decision-making encompasses evidence-based treatments in addition to environmental and lifestyle factors.

“Patients with MS are often very interested and involved in their own disease management and therefore should be empowered to play an active role in their care,” said author Amy Perrin Ross, APN, MSN, CNRN, MSCN. “Shared decision-making is therefore essential to optimal treatment and quality of life for patients with MS.”

Clinicians educate the patient on their disease and provide recommendations based on elements such as risk factors, genetic factors, and potential triggers.

“After reviewing and educating patients about the available options, clinicians should take time to listen to the patient and learn about their values and preferences, as these should be taken into account during consideration of optimal treatment,” Perrin Ross said. “The more patients are involved in shared decision-making, the more likely they will be adherent to the therapy and lifestyle recommendations we might be making for them.”

Shared decision-making involves 5 steps: engage patient participation; explore and compare treatment options; assess patient values and preferences; come to a decision on treatment with the patient; and evaluate the patient decision.

This comprehensive team approach can include a neurologist, nurse, physician assistant, primary care provider, physical therapist, occupational therapist, speech therapist, podiatrist, psychiatrist, urologist, nutritionist, and pharmacist. Additionally, a nurse coordinator or case manager can help coordinate care and provide patients with guidance.

Although this approach can be time consuming, there is payoff in the end. The more patients feel supported, “the more comfortable they are to manage their own disease and feel empowered to make decisions about their care and their lives,” Perrin Ross said.