Medical Park Loipl, Bischofswiesen, Germany.
Università di Roma Tor Vergata, Rome & IRCCS Neuromed, Pozzilli, IS, Italy.
Mult Scler Relat Disord. 2018 Jan;19:153-160. doi: 10.1016/j.msard.2017.11.013. Epub 2017 Nov 21.
Patient engagement is vital in multiple sclerosis (MS) in order to optimise outcomes for patients, society and healthcare systems. It is essential to involve all stakeholders in potential solutions, working in a multidisciplinary way to ensure that people with MS (PwMS) are included in shared decision-making and disease management. To start this process, a collaborative, open environment between PwMS and healthcare professionals (HCPs) is required so that similarities and disparities in the perception of key areas in patient care and unmet needs can be identified. With this patient-centred approach in mind, in 2016 the MS in the 21st Century Steering Group formed a unique collaboration to include PwMS in the Steering Group to provide a platform for the patient voice.
The MS in the 21st Century initiative set out to foster engagement through a series of open-forum joint workshops. The aims of these workshops were: to identify similarities and disparities in the perception and prioritisation in three key areas (unmet needs, the treatment burden in MS, and factors that impact patient engagement), and to provide practical advice on how the gaps in perception and understanding in these key areas could be bridged.
Combined practical advice and direction are provided here as eight actions: 1. Improve communication to raise the quality of HCP-patient interaction and optimise the limited time available for consultations. 2. Heighten the awareness of 'hidden' disease symptoms and how these can be managed. 3. Improve the dialogue surrounding the benefit versus risk issues of therapies to help patients become fully informed and active participants in their healthcare decisions. 4. Provide accurate, lucid information in an easily accessible format from reliable sources. 5. Encourage HCPs and multidisciplinary teams to acquire and share new knowledge and information among their teams and with PwMS. 6. Foster greater understanding and awareness of challenges faced by PwMS and HCPs in treating MS. 7. Collaborate to develop local education, communication and patient-engagement initiatives. 8. Motivate PwMS to become advocates for self-management in MS care.
Our study of PwMS and HCPs in the MS in the 21st Century initiative has highlighted eight practical actions. These actions identify how differences and gaps in unmet needs, treatment burden, and patient engagement between PwMS and HCPs can be bridged to improve MS disease management. Of particular interest now are patient-centred educational resources that can be used during time-limited consultations to enhance understanding of disease and improve communication. Actively bridging these gaps in a joint approach enables PwMS to take part in shared decision-making; with improved communication and reliable information, patients can make informed decisions with their HCPs, as part of their own personalised disease management.
在多发性硬化症(MS)中,患者的参与至关重要,这样才能优化患者、社会和医疗体系的治疗效果。让所有利益相关者参与到潜在的解决方案中非常重要,通过多学科的方式共同努力,以确保 MS 患者(PwMS)能够参与到共同决策和疾病管理中来。为了实现这一目标,需要在 PwMS 和医疗保健专业人员(HCPs)之间建立一个协作、开放的环境,以便能够发现患者护理和未满足需求的关键领域的看法中的相似之处和差异。考虑到这种以患者为中心的方法,2016 年,21 世纪 MS 指导小组成立了一个独特的合作组织,让 PwMS 参与指导小组,为患者的声音提供一个平台。
21 世纪 MS 倡议旨在通过一系列开放式论坛联合研讨会来促进参与。这些研讨会的目的是:确定在三个关键领域(未满足的需求、MS 治疗负担以及影响患者参与的因素)的看法和优先级方面的相似之处和差异,并就如何弥合这些关键领域中看法和理解上的差距提供切实可行的建议。
这里提供了八项行动的综合实用建议和指导:1. 改善沟通,提高 HCP-患者互动的质量,并优化咨询的有限时间。2. 提高对“隐藏”疾病症状的认识,并学会如何管理这些症状。3. 改善围绕治疗益处与风险问题的对话,以帮助患者充分了解并积极参与他们的医疗保健决策。4. 提供来自可靠来源的准确、清晰的易于访问格式的信息。5. 鼓励 HCPs 和多学科团队在团队内部以及与 PwMS 之间获取和分享新知识和信息。6. 增进对 PwMS 和 HCPs 在治疗 MS 方面所面临挑战的理解和认识。7. 合作制定当地的教育、沟通和患者参与计划。8. 激励 PwMS 成为 MS 护理自我管理的倡导者。
我们对 21 世纪 MS 倡议中的 PwMS 和 HCPs 的研究强调了八项切实可行的行动。这些行动确定了如何弥合 PwMS 和 HCPs 在未满足的需求、治疗负担和患者参与方面的差异和差距,以改善 MS 疾病管理。目前特别关注的是患者为中心的教育资源,这些资源可以在有限的时间内的咨询中使用,以提高对疾病的理解和沟通。通过联合方法积极弥合这些差距,使 PwMS 能够参与共同决策;通过改善沟通和提供可靠的信息,患者可以在 HCP 的帮助下做出明智的决策,这是他们个性化疾病管理的一部分。