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Factors associated with treatment escalation among MS specialists and general neurologists: Results from an International cojoint study
G. Saposnik, S. Andhavarapu, Ó. Fernández, HJ. Kim, H. Wiendl, M. Foss, F. Zuo, EK. Havrdová, E. Celius, F. Caceres, M. Magyari, R. Bermel, A. Costa, M. Terzaghi, T. Kalincik, V. Popescu, MP. Amato, X. Montalban, J. Oh
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články
- MeSH
- lidé MeSH
- neurologové * MeSH
- recidiva MeSH
- roztroušená skleróza * farmakoterapie terapie MeSH
- specializace MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Previous studies in multiple sclerosis (MS) showed that therapeutic inertia (TI) affects 60-90% of neurologists and up to 25% of daily treatment decisions. The objective of this study was to determine the most common factors and attribute levels associated with decisions to treatment escalation in an international study in MS care. METHODS: 300 neurologists with MS expertise from 20 countries were invited to participate. Participants were presented with 12 pairs of simulated MS patient profiles described by 13 clinically relevant factors. We used disaggregated discrete choice experiments to estimate the weight of factors and attributes affecting physicians' decisions when considering treatment selection. Participants were asked to select the ideal candidate for treatment escalation from modest to higher-efficacy therapies. RESULTS: Overall, 229 neurologists completed the study (completion rate: 76.3%). The top 3 weighted factors associated with treatment escalation were: previous relapses (20%), baseline expanded disability status scale [EDSS] (18%), and MRI activity (13%). Patient demographics and desire for pregnancy had a modest influence (≤ 3%). We observed differences in the weight of factors associated with treatment escalation between MS specialists and non-MS specialists. CONCLUSIONS: Our results provide critical information on factors influencing neurologists' treatment decisions and should be applied to continuing medical education strategies.
Bootstrap Analytics Calgary Canada
Danish Multiple Sclerosis Center University Hospital Rigshospitalet Copenhagen Denmark
Department of Neurofarba IRCCS Fondazione Don Carlo Gnocchi University of Florence Florence Italy
Department of Neurology Institute of Translational Neurology University of Münster Germany
Director and Founder NeuroEconSolutions© Toronto Canada
Hasselt University Hasselt Belgium
Institute of Restorative Neurosciences Buenos Aires Argentina
Li Ka Shing Knowledge Institute St Michael's Hospital University of Toronto Canada
Mellen Center for Multiple Sclerosis Cleveland Clinic Cleveland OH United States
Citace poskytuje Crossref.org
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- $a Saposnik, G $u Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, 55 Queen St E, Toronto, Ontario M5C 1R6, Canada; Director and Founder, NeuroEconSolutions© (www.neuroeconsolutions.com), Toronto, Canada; Clinical Outcomes and Decision Neuroscience Unit, St Michael's Hospital, University of Toronto, Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Canada. Electronic address: gustavo.saposnik@unityhealth.to
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- $a BACKGROUND: Previous studies in multiple sclerosis (MS) showed that therapeutic inertia (TI) affects 60-90% of neurologists and up to 25% of daily treatment decisions. The objective of this study was to determine the most common factors and attribute levels associated with decisions to treatment escalation in an international study in MS care. METHODS: 300 neurologists with MS expertise from 20 countries were invited to participate. Participants were presented with 12 pairs of simulated MS patient profiles described by 13 clinically relevant factors. We used disaggregated discrete choice experiments to estimate the weight of factors and attributes affecting physicians' decisions when considering treatment selection. Participants were asked to select the ideal candidate for treatment escalation from modest to higher-efficacy therapies. RESULTS: Overall, 229 neurologists completed the study (completion rate: 76.3%). The top 3 weighted factors associated with treatment escalation were: previous relapses (20%), baseline expanded disability status scale [EDSS] (18%), and MRI activity (13%). Patient demographics and desire for pregnancy had a modest influence (≤ 3%). We observed differences in the weight of factors associated with treatment escalation between MS specialists and non-MS specialists. CONCLUSIONS: Our results provide critical information on factors influencing neurologists' treatment decisions and should be applied to continuing medical education strategies.
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