Exploration of factors which influence treatment decisions of patients with Multiple Sclerosis

Abstract

Introduction: The past ten years have brought a wide variety of therapeutic options to Australian patients with Relapsing Remitting Multiple Sclerosis (RRMS). In a complex treatment landscape for an unpredictable disease, it is important to understand the factors that influence decision-making. In this study we assess how patients view the various factors and information sources that contribute to making an informed choice.

Objectives: Identify the factor rated by Patients with RRMS (PwRRMS) as having the most important influence on treatment choice. Identify in rank order other factors important in making this decision, level of satisfaction with process around choosing treatment and comfort with treatment choice.

Methods: This non-interventional, exploratory study prospectively enrolled 78 patients assigned to one of three groups:

1. Initial treatment (n=25) 2. Switching to an alternate treatment (n=27) 3. Stable on treatment 12 - 24 months (n=26)

Treatment naïve and patients switching treatments were enrolled within one month of treatment decision. Baseline demographic and MS data was collected. Participants completed the survey where they rated ten factors from most important to least important: Drug safety; Efficacy; Ease of use; Mode of administration; Mechanism of action; Concern about disability; Requirement for follow-up safety monitoring; Balance of risk/benefit; Value of discussion with MS nurse & neurologist.

Results: The factors ranked first by most participants in influencing treatment choice were (in order):

1. Concern about disability (31/78 participants) 2. Perception of efficacy (16/78 participants) 3. Perception of safety (11/78 participants)

This ranking order was consistent across all groups. 97% of participants were satisfied with the process around choosing treatment and 92% reported they felt very or entirely comfortable with their treatment decision.

Conclusions: Our data indicates that concern about disability is the most important driving factor for PwRRMS in choosing between treatments regardless of whether they are starting for the first time, planning a switch in therapy or are currently stable on an MS medication.