A Novel Educational Program for Relationship-Centered Shared Decision Making in Multiple Sclerosis, with a Focus on Cognition

Background: An unmet need exists for an educational program on effective communication between people with multiple sclerosis (pwMS) and their healthcare providers (HCPs). Connecting with the patient (pt) and collaborating on care decisions are fundamental principles of healthcare. Our aim is to build on co-constructing the narrative with the pt. This is particularly needed for addressing cognitive impairment in pwMS which is associated with unemployment (Kobelt et al, 2019; Campbell et al, 2017), disability pension and sickness/absence from work (Kavaliunas et al, 2017), and auto violations (Dehning 2014; Schultheis 2002). We will present an educational program for relationship-centered care in SDM (RCSDM).

Objectives: The authors partnered with the Multiple Sclerosis Association of America to confirm the need for an educational program for RCC that will focus and raise awareness of CI in pwMS. The goal is to demonstrate to the healthcare community ways to improve communication between pwMS and their HCPs.

Methods: Literature searches using keywords shared decision making (SDM), relationship centered care, multiple sclerosis, cognition, medical communication revealed no articles relating to effective HCP-pt communication, SDM in MS, and CI (Cochrane database, 2022). Advisory board meetings were conducted separately with neurologists, advanced practice providers and pwMS. Feedback was received on HCP-pt interactions, focusing on assessment and management of CI in routine care. HCP advisors were tasked with evaluating a novel evidence-informed approach to RCSDM describing communication skills to: 1) build strong HCP-pt connections; 2) co-construct meaningful illness narratives; and 3) collaborate on action planning.

Results: The advisory board meeting with PwMS confirmed that CI issues are often ignored. The feedback from two HCP advisory board meetings confirmed the importance of CI in MS but revealed a lack of consistency in approach to CI in MS. All three groups confirmed the need for an educational program for MS providers in RCSDM, focusing on cognition. Authors identified the potential for an RCSDM program to improve HCP-pt communication.

Conclusions: An educational program on RCSDM, focusing on CI, will teach HCPs skills to more efficiently and effectively, 1) connect with pts, 2) co-construct meaningful illness narratives and 3) collaborate on action planning for care. This approach will help providers uncover CI earlier, understand their pts more completely, and better collaborate for improved outcomes.