Contributions
Abstract: P620
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Introduction: Clinicians have the challenge to tailor MS treatment based on activity level, individual patient characteristics/preferences, and their personal expertise/preference, in order to identify the optimal balance between efficacy and safety. In this process, clinicians" risk preferences may determine in part whether or not risky treatment options are selected. However, limited information is currently available on whether or not risk preference is associated with the MS management.
Objectives: To determine the influence of clinicians" risk preferences in therapeutic decisions of MS progression, using principles and methods from behavioral economics.
Design: A web-based study comprising 96 neurologists with expertise in MS care from across Spain was conducted. Participants answered questions regarding the management of 20 case-scenarios commonly encountered in clinical practice, questions from the Socio-Economic Panel Study related to risk preferences in different domains (e.g. health, financial, faith in other people, driving), and standardized questions about financial risk-taking developed with principles from behavioral economics . Specifically, participants were asked to choose the minimal amount of Euros they would prefer instead of the 50/50 option of winning 400 or 0 Euros. Risk seeking was defined as the preference for the financial option that was higher than the certainty equivalent (200 Euros). MS progression was defined as worsening of ≥ 1 point on the EDSS scale. Management errors were defined according to a consensus of MS experts. Multivariable analysis was adjusted by age, sex, specialty status (general neurologist vs. MS specialist).
Results: Overall, 96 of 160 invited participants completed the survey (response rate: 60%). Mean age: 40±8.5 years, 53% female. MS specialists represented 67% of participants; mean number of patients seen per week: 25±21 with a mean of 15±11 years in clinical practice. A higher number of MS patients seen per week was associated with higher willingness to take risks in different domains (p< 0.006). MS specialists were less likely to make errors in cases with evidence of disease progression (adjusted OR 0.23; 95%CI 0.07-0.74). Higher risk seeking was associated with management errors in cases with MS progression (adjusted OR 4.9; 95%CI 1.4-17.0).
Conclusions: Willingness to take risk influenced therapeutic decision in MS care. Higher expertise in MS care was associated with lower management errors.
Disclosure: The study was sponsored by the Sociedad Española de Neurologia (SEN) and funded by an operating grant from Roche Farma Spain.
D Prefasi and J Maurino are employees of Roche Farma Spain.
G Saposnik, R Raptis, D Selchen, CC Ruff, PN Tobler: nothing to disclose.
Abstract: P620
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Introduction: Clinicians have the challenge to tailor MS treatment based on activity level, individual patient characteristics/preferences, and their personal expertise/preference, in order to identify the optimal balance between efficacy and safety. In this process, clinicians" risk preferences may determine in part whether or not risky treatment options are selected. However, limited information is currently available on whether or not risk preference is associated with the MS management.
Objectives: To determine the influence of clinicians" risk preferences in therapeutic decisions of MS progression, using principles and methods from behavioral economics.
Design: A web-based study comprising 96 neurologists with expertise in MS care from across Spain was conducted. Participants answered questions regarding the management of 20 case-scenarios commonly encountered in clinical practice, questions from the Socio-Economic Panel Study related to risk preferences in different domains (e.g. health, financial, faith in other people, driving), and standardized questions about financial risk-taking developed with principles from behavioral economics . Specifically, participants were asked to choose the minimal amount of Euros they would prefer instead of the 50/50 option of winning 400 or 0 Euros. Risk seeking was defined as the preference for the financial option that was higher than the certainty equivalent (200 Euros). MS progression was defined as worsening of ≥ 1 point on the EDSS scale. Management errors were defined according to a consensus of MS experts. Multivariable analysis was adjusted by age, sex, specialty status (general neurologist vs. MS specialist).
Results: Overall, 96 of 160 invited participants completed the survey (response rate: 60%). Mean age: 40±8.5 years, 53% female. MS specialists represented 67% of participants; mean number of patients seen per week: 25±21 with a mean of 15±11 years in clinical practice. A higher number of MS patients seen per week was associated with higher willingness to take risks in different domains (p< 0.006). MS specialists were less likely to make errors in cases with evidence of disease progression (adjusted OR 0.23; 95%CI 0.07-0.74). Higher risk seeking was associated with management errors in cases with MS progression (adjusted OR 4.9; 95%CI 1.4-17.0).
Conclusions: Willingness to take risk influenced therapeutic decision in MS care. Higher expertise in MS care was associated with lower management errors.
Disclosure: The study was sponsored by the Sociedad Española de Neurologia (SEN) and funded by an operating grant from Roche Farma Spain.
D Prefasi and J Maurino are employees of Roche Farma Spain.
G Saposnik, R Raptis, D Selchen, CC Ruff, PN Tobler: nothing to disclose.