title: Individualizing treatment goals and interventions for people with MS.
abstract: OBJECTIVE
  The aim of this article is to consider factors that should be evaluated in the selection of therapy for people with multiple sclerosis (MS). This includes a review of current approaches to treatment selection and how to align this process with patients' treatment goals. These issues have increased in importance with the availability of new disease-modifying therapies and will continue to do so as more novel treatments are approved.
  
  
  RESULTS
  The model for decision making in the management of people with MS as well as other chronic diseases has evolved from one in which medication is prescribed by the neurologist and the person is expected to comply with treatment, to one in which the neurologist and individual with MS achieve concordance with respect to both the expectations and goals of therapy and the means to achieve them. This shift has resulted in a requirement for easily understood evidence-based information about the risks and benefits of different treatment alternatives. It has been demonstrated that providing MS sufferers with such information increases effective self-management and satisfaction.
  
  
  CONCLUSIONS
  Healthcare providers involved in the treatment of MS have an increased responsibility to ensure people with this disease, their partners, and when appropriate, their families are involved in all decisions regarding care. This includes helping to select and adjust therapy on the basis of the individual MS sufferer's characteristics and needs that are likely to evolve as the disease progresses.
authors.affiliation: Centre for Neuroscience and Trauma, Barts and the London School of Medicine and Dentistry, London, UK. g.giovannoni@qmul.ac.uk
authors.forename: Gavin
authors.initials: G
authors.lastname: Giovannoni
authors.forename: Robert W
authors.initials: RW
authors.lastname: Rhoades
mesh_terms: D003657:Decision Making; D006040:Goals; D006801:Humans; D009103:Multiple Sclerosis / Q000523:psychology / Q000628:therapy*; D018579:Patient Selection; D057285:Precision Medicine