From medical prescription to patient compliance. A qualitative insight into the neurologist-patient relationship in multiple sclerosis - EHESP - École des hautes études en santé publique Access content directly
Journal Articles International Journal of MS Care Year : 2018

From medical prescription to patient compliance. A qualitative insight into the neurologist-patient relationship in multiple sclerosis

Abstract

Background: Approximately 12 disease-modifying treatments are available worldwide for patients with relapsing multiple sclerosis (MS). These recent therapeutic advances have led to major changes in patient and neurologist attitudes toward drug prescription. Herein, we aimed to characterize patient choice regarding treatment for MS and identify how neurologists assess and monitor patient compliance during follow-up. Methods: In 29 patients with MS, we observed visits to their neurologist to understand how questions related to compliance were addressed in the doctor-patient relationship. Face-to-face interviews were conducted with 15 of the 29 patients to discuss how they dealt with their drug prescription from a patientcentered perspective. Results: Of the 15 patients with MS, nine were offered a choice of treatment. However, we found that neurologists were not always willing to consider the patients' input. Even if physicians attempt to align treatment choice with patient preferences to ensure compliance, preferences are often assumed rather than solicited from patients. Furthermore, patients may be unwilling to make their own treatment decisions. Various ways for neurologists to assess compliance during visits were also identified. Noncompliance can be considered as a way for patients to communicate their preferences and demonstrate involvement in their drug therapy, and it can lead to a renegotiation of the current treatment course. Conclusions: These findings suggest that the neurologist-patient relationship has a great influence on patient compliance throughout the MS disease course. © 2018 Consortium of Multiple Sclerosis Centers.

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Dates and versions

hal-02043814 , version 1 (21-02-2019)

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V. Schlegel, Emmanuelle Leray. From medical prescription to patient compliance. A qualitative insight into the neurologist-patient relationship in multiple sclerosis. International Journal of MS Care, 2018, 20 (6), pp.279-286. ⟨10.7224/1537-2073.2017-043⟩. ⟨hal-02043814⟩
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