Perspective of Disease and Treatment in Patients with Multiple Sclerosis: A Polish Multi-center Study.

IF 4.8 3区 医学 Q1 CLINICAL NEUROLOGY
Justyna Chojdak-Łukasiewicz, Alina Kułakowska, Joanna Tarasiuk, Katarzyna Kapica-Topczewska, Joanna Siuda, Weronika Galus, Maja Patalong-Ogiewa, Aleksandra Kaczmarczyk, Anetta Lasek-Bal, Ewa Krzystanek, Arkadiusz Stęposz, Aleksandra Karuga, Elżbieta Jasińska, Katarzyna Gołuch, Waldemar Brola, Martyna Odzimek, Agnieszka Słowik, Klaudia Kaczówka, Marcin Wnuk, Monika Marona, Konrad Rejdak, Anna Jamroz-Wiśniewska, Mariusz Stasiołek, Bartosz Bielecki, Mariola Świderek-Matysiak, Małgorzata Siger, Andrzej Głąbiński, Marta Milewska-Jędrzejczak, Beata Łabuz-Roszak, Małgorzata Gardzińska, Maja Sakowska, Halina Bartosik-Psujek, Iwona Rościszewska-Żukowska, Małgorzata Popiel, Julia Rudnicka-Czerwiec, Andrzej Potemkowski, Monika Adamczyk-Sowa, Katarzyna Kubicka-Bączyk, Natalia Niedziela, Aleksandra Kołtuniuk, Sławomir Budrewicz, Anna Pokryszko-Dragan
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引用次数: 0

Abstract

Introduction: Due to recent progress in multiple sclerosis (MS) research, a range of disease-modifying therapies (DMT) is increasingly available. According to the personalized therapeutic approach, the choice of DMT for a particular patient is based on complex analysis of disease-related and drug-related aspects, with emphasis on patient's preferences and shared decision-making. The aim of this study was to evaluate the perspective of the disease and various aspects of treatment in Polish patients with MS (pwMS), with reference to sociodemographic and clinical data.

Methods: The nationwide survey was conducted, addressed to adult pwMS treated with DMT and undergoing regular follow-up in regional MS Centers. The questionnaire contained sociodemographic data, and questions about major troublesome and feared aspects of disease, and about the importance of various aspects of treatment. In addition, MS-related data were provided by neurologists. The responses have been summarized and analyzed for their relationships with sociodemographic and clinical data.

Results: A total of 2032 pwMS (70% women; mean age 42.1 ± 10.8 years) were included from 14 MS Centers. Over 90% had relapsing-remitting MS, mean disease duration was 12 years and the median Expanded Disability Status Scale (EDSS) was 2.4 ± 1.5. Fatigue (50%), limb weakness (47%), and balance and gait disturbances (30%) were the most common and troublesome symptoms reported by the respondents. Their main concerns about disease consequences included disability (46%) and dependence on others (17%). All aspects of DMT efficacy were very important for more than 70% of patients, with preventing disability progression, maintaining social participation, and reduction of relapses as top priorities (86-95%). Treatment safety concerns were focused on risk of cancer (74%), effect on comorbidities (63%), and severe infections (60%). Drug efficacy (93%), modernity (60%), and mechanism of action (59%) were most commonly indicated factors influencing patients' preference for DMT. Significant relationships were found between pwMS opinion about aspects of treatment and their age, sex, family status and vocational activity, as well as type and duration of MS, EDSS score, and type of DMT used.

Conclusion: The Polish pwMS perspective of disease is focused on emerging disability and its social context. Regarding aspects of treatment, sufferers are highly concerned about its efficacy (especially in preventing the mentioned disease consequences), followed by safety and convenience. Individual differences in patients' responses should be highlighted, associated with combined impact of demographic and clinical data. The study findings should inform complex and personalized therapeutic approaches to MS management in clinical practice.

多发性硬化症患者的疾病和治疗视角:波兰多中心研究
导论:由于最近在多发性硬化症(MS)的研究进展,一系列的疾病改善疗法(DMT)是越来越多的可用。根据个性化治疗方法,对特定患者的DMT选择是基于对疾病相关和药物相关方面的复杂分析,强调患者的偏好和共同决策。本研究的目的是评估波兰多发性硬化症(pwMS)患者的疾病前景和治疗的各个方面,参考社会人口学和临床数据。方法:在全国范围内进行调查,针对接受DMT治疗的成年pwMS,并在区域MS中心进行定期随访。调查问卷包含社会人口统计数据,以及关于疾病的主要麻烦和恐惧方面的问题,以及关于治疗各个方面的重要性的问题。此外,ms相关数据由神经科医生提供。我们总结并分析了这些反应与社会人口学和临床数据的关系。结果:14个MS中心共纳入2032例pwMS患者(70%为女性,平均年龄42.1±10.8岁)。超过90%的患者患有复发缓解型MS,平均病程为12年,中位扩展残疾状态量表(EDSS)为2.4±1.5。疲劳(50%)、肢体无力(47%)、平衡和步态障碍(30%)是受访者报告的最常见和最麻烦的症状。他们对疾病后果的主要担忧包括致残(46%)和依赖他人(17%)。对于70%以上的患者来说,DMT疗效的所有方面都非常重要,预防残疾进展、保持社会参与和减少复发是最重要的(86-95%)。治疗安全性问题主要集中在癌症风险(74%)、对合并症的影响(63%)和严重感染(60%)。药物疗效(93%)、时代性(60%)和作用机制(59%)是影响患者选择DMT的最常见因素。pwMS对治疗方面的看法与其年龄、性别、家庭状况和职业活动、MS类型和持续时间、EDSS评分和使用的DMT类型之间存在显著关系。结论:波兰pwMS对疾病的看法侧重于新出现的残疾及其社会背景。在治疗方面,患者高度关注其疗效(特别是预防上述疾病后果),其次是安全性和便利性。应强调患者反应的个体差异,并结合人口统计学和临床数据的综合影响。研究结果应该为临床实践中多发性硬化症管理的复杂和个性化治疗方法提供信息。
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来源期刊
Neurology and Therapy
Neurology and Therapy CLINICAL NEUROLOGY-
CiteScore
5.40
自引率
8.10%
发文量
103
审稿时长
6 weeks
期刊介绍: Aims and Scope Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice. Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Neurology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted, it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model, this allows for the rapid and efficient communication of the latest research and reviews to support scientific discovery and clinical practice. Open Access All articles published by Neurology and Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts. Digital Features and Plain Language Summaries Neurology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case-by-case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviews conflict, an Editorial Board Member will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed. Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised, it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor, and authors are welcome to make rebuttals against individual reviewer comments, if appropriate. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Copyright Neurology and Therapy is published under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0. Contact For more information about the journal, including pre-submission enquiries, please contact managing editor Lydia Alborn at lydia.alborn@springer.com.
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