Imperial College London
Alternate

ProfessorRichardNicholas

Faculty of Medicine, Department of Brain Sciences

Professor of Practice (Neurology)
 
 
 
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Contact

 

r.nicholas

 
 
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Location

 

12L12CLab BlockCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wilkie:2020:10.1177/2055217320959802,
author = {Wilkie, D and Solari, A and Nicholas, R},
doi = {10.1177/2055217320959802},
journal = {Multiple Sclerosis Journal - Experimental, Translational and Clinical},
pages = {1--11},
title = {The impact of the face-to-face consultation on decisional conflict in complex decision-making in multiple sclerosis: a pilot study},
url = {http://dx.doi.org/10.1177/2055217320959802},
volume = {6},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe role of face-to-face consultations in medicine is increasingly being challenged. Disease activity, national guidelines, life goals e.g. pregnancy, multiple therapies and side effects need to be considered on starting disease modifying treatments (DMTs) in people with multiple sclerosis (pwMS). ObjectivesWe studied the impact of a face-to-face consultation on decision making, using decisional conflict (DC) as the primary outcome. MethodsProspective cohort study of 73 pwMS attending clinics who were making decisions about DMTs followed for one year. Prerequisites and consultation features were measured with the SURE scale for DC used as the primary outcome at baseline and at one year.ResultsThe patient activation measure (PAM) was the only driver prior to the consultation associated with DC (p=0.02) showing those less engaged were more likely to have DC.  Overall, 51/73 (70%) of people made their treatment decision or reinforced a former decision during the consultation.  We found making a treatment decision between the original consultation and the follow-up was associated with resolving DC (p=0.008).Conclusions Patient engagement impacts DC but the HCP delivering the optimal Shared Decision Making (SDM) approach is additionally significant in reducing DC. In complex decisions there is a clear role for face-to-face consultations in current practice.
AU  - Wilkie,D
AU  - Solari,A
AU  - Nicholas,R
DO  - 10.1177/2055217320959802
EP  - 11
PY  - 2020///
SN  - 2055-2173
SP  - 1
TI  - The impact of the face-to-face consultation on decisional conflict in complex decision-making in multiple sclerosis: a pilot study
T2  - Multiple Sclerosis Journal - Experimental, Translational and Clinical
UR  - http://dx.doi.org/10.1177/2055217320959802
UR  - https://journals.sagepub.com/doi/10.1177/2055217320959802
UR  - http://hdl.handle.net/10044/1/82788
VL  - 6
ER  -
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