title: The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction.
abstract: BACKGROUND
  Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life.
  
  
  METHODS
  A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice.
  
  
  RESULTS
  A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT); satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment. Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so.
  
  
  CONCLUSIONS
  Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment.
authors.affiliation: Multiple Sclerosis Centre of Catalonia, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Tintoré
authors.affiliation: European Multiple Sclerosis Platform, Brussels, Belgium.
authors.forename: Maggie
authors.initials: M
authors.lastname: Alexander
authors.affiliation: National Multiple Sclerosis Society, Denver, CO, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Costello
authors.affiliation: Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Duddy
authors.affiliation: Department of Neurology, University of Virginia, Charlottesville, VA, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Jones
authors.affiliation: Nancy Law Consulting LLC, Parker, CO, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Law
authors.affiliation: Biogen, Cambridge, MA, USA.
authors.forename: Gilmore
authors.initials: G
authors.lastname: O'Neill
authors.affiliation: Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Uccelli
authors.affiliation: Department of Neurology, University of Regensburg, Regensburg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Weissert
authors.affiliation: Hope Neurology Multiple Sclerosis Center, Knoxville, TN, USA.
authors.forename: Sibyl
authors.initials: S
authors.lastname: Wray
keywords: health care provider survey; multiple sclerosis; patient survey; patient-health care provider relationship; treatment expectations; treatment satisfaction