OBJECTIVES

: Decision aids (DAs) are used to facilitate patient participation and help make informed therapeutic decisions. With an ever-increasing number of treatments available for patients with multiple sclerosis (MS), there is a need to understand the effect of shared decision-making (SDM) between patients and neurologists. The study objectives were to conduct a systematic review to identify DAs utilized in MS and explore their impact on SDM.

METHODS

: A systematic literature review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search identified English-language articles from PubMed, CINAHL, and PsycINFO databases. Review articles, thesis/dissertations, editorials, case studies, pediatric studies, and studies including patients with cognitive impairment or disabilities were excluded from the review.

RESULTS

: A total of 53 articles were identified, of which 11 studies were accepted for review based on the inclusion/exclusion criteria. All but one study was conducted outside of the United States, with majority 8 (73%) conducted in Germany. Among the 11 studies, 6 studies (54%) focused on the use of DAs and assessed outcomes such as patient preferences, understanding, knowledge, and disease management. A variety of DA formats were utilized, including educational program (1; 16%), printed materials (3; 50%), graphic format (1; 16%), and a software program (1; 16%). The DA’s utilized as printed material included a range of 6, 12, and 30 items each whereas the educational program was a 4-hour session. The web-based DA covered 3 domains and included figures demonstrating treatment effects and risks.

CONCLUSIONS

: Although a variety of DAs have been identified in MS, a need for a robust tool exists. By inappropriately assuming the patient’s scientific understanding, no current tool has extensively explored the patient’s outlook towards different treatments. Currently, a tool including both the patient’s willingness to participate and understanding of treatment options does not exist.