title: Patient education programme on immunotherapy in multiple sclerosis (PEPIMS): a controlled rater-blinded study.
abstract: OBJECTIVE
  To investigate the effectiveness of a multi-component evidence-based education programme on disease modifying therapies in multiple sclerosis.
  
  
  METHODS
  Controlled trial with two consecutive patient cohorts and a gap of two months between cohorts.
  
  
  METHODS
  Three neurological rehabilitation centres.
  
  
  METHODS
  Patients with multiple sclerosis within rehabilitation.
  
  
  METHODS
  Control group (CG) participants were recruited and received standard information. Two months later, intervention group (IG) participants were recruited and received a six-hour nurse-led interactive group education programme consisting of two parts and a comprehensive information brochure.
  
  
  METHODS
  Primary endpoint was "informed choice", comprising of adequate risk knowledge in combination with congruency between attitude towards immunotherapy and actual immunotherapy uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and depression, self-efficacy, and fatigue.
  
  
  RESULTS
  A total of 156 patients were included (IG=75, CG=81). The intervention led to significantly more participants with informed choice (IG: 47% vs. CG: 23%, P=0.004). The rate of persons with adequate risk knowledge was significantly higher in the IG two weeks after the intervention (IG: 54% vs. CG: 31%, P=0.007), but not after six months (IG: 48% vs. CG: 31%, P=0.058). No significant differences were shown for positive attitude towards disease modifying therapy (IG: 62% vs. CG: 71%, P=0.29) and for disease modifying therapy status after six months (IG: 61.5% vs CG: 68.6%, P=0.39). Also no differences were found for autonomy preferences and decisional conflict after six months.
  
  
  CONCLUSIONS
  Delivering evidence-based information on multiple sclerosis disease modifying therapies within a rehabilitation setting led to a marked increase of informed choices.
authors.affiliation: 1 Institute of Social Medicine, University of Lübeck, Lübeck, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Köpke
authors.affiliation: 2 Department of Health and Caring Sciences, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Kasper
authors.affiliation: 3 Neurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Flachenecker
authors.affiliation: 3 Neurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Meißner
authors.affiliation: 4 Department of Neurology, Segeberger Kliniken, Bad Segeberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Brandt
authors.affiliation: 4 Department of Neurology, Segeberger Kliniken, Bad Segeberg, Germany.|5 Department of Therapeutic Sciences, MSH Medical School Hamburg, Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hauptmann
authors.affiliation: 6 RehaCentre Hamburg, Hamburg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Bender
authors.affiliation: 7 Unit of Health Sciences and Education, MIN Faculty, University of Hamburg, Hamburg, Germany.|8 Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Backhus
authors.affiliation: 7 Unit of Health Sciences and Education, MIN Faculty, University of Hamburg, Hamburg, Germany.|8 Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: A C
authors.initials: AC
authors.lastname: Rahn
authors.affiliation: 8 Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Pöttgen
authors.affiliation: 9 Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Vettorazzi
authors.affiliation: 8 Institute of Neuroimmunology & Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Heesen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D015588:Observer Variation; D010353:Patient Education as Topic / Q000458:organization & administration*; D011379:Prognosis; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Education; controlled clinical trial; multiple sclerosis; neurological rehabilitation