title: Interventions to support risk and benefit understanding of disease-modifying drugs in Multiple Sclerosis patients: A systematic review.
abstract: The present review evaluates interventions that have been designed to improve understanding of the complex risk-benefit profiles of disease-modifying drugs (DMDs) in patients with Multiple Sclerosis (MS).
  
  
  
  A systematic search conducted using PubMed, Embase, Google Scholar and PsycINFO identified 15 studies. Interventions which provided treatment information were present across a range of study designs. A narrative synthesis was conducted due to heterogeneity of research findings.
  
  
  
  Interventions providing treatment information ranged from comprehensive education programmes to booklets of a few pages. MS patients favoured the interventions they received. Understanding of overall treatment information and treatment risks specifically, generally improved following interventions. Yet overestimation of treatment benefits persisted. There was no conclusive effect on DMD decisions. No superior intervention was identified.
  
  
  
  Interventions designed to improve understanding of DMD risk and benefit information are moderately successful.
  
  
  
  Additional support provided to MS patients beyond routine healthcare can generally improve understanding of the complex risk-benefit profiles of DMDs. Future interventions need to ensure that patients with symptoms that may confound understanding can also benefit from this additional information.
authors.affiliation: Department of Psychology, Royal Holloway, University of London, Egham, UK. Electronic address: Gurpreet.reen.2014@live.rhul.ac.uk.
authors.forename: Gurpreet K
authors.initials: GK
authors.lastname: Reen
authors.affiliation: Department of Neurology, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
authors.forename: Eli
authors.initials: E
authors.lastname: Silber
authors.affiliation: Department of Psychology, Royal Holloway, University of London, Egham, UK.
authors.forename: Dawn W
authors.initials: DW
authors.lastname: Langdon
mesh_terms: D003657:Decision Making; D018450:Disease Progression; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000523:psychology*; D010353:Patient Education as Topic; D018802:Patient-Centered Care
chemical_list: D007166:Immunosuppressive Agents
keywords: Benefits; Disease-modifying drugs; Evidence-based patient information; Intervention; Multiple Sclerosis; Risks; Systematic review; Understanding