Care Cues: Improving Joint Decision-Making in Multiple Sclerosis

Ilana Katz Sand, MD; Gretchen K. Mathewson, FNP-BC, CMSN


October 15, 2021

Multiple sclerosis is a complex neurologic disease for which numerous treatment options are available. Add to that the variations in patient tolerance of symptoms and expectations of quality of life, and the challenges clinicians face to individualize treatment multiply.

In this episode of Care Cues, Dr Ilana Katz Sand and nurse practitioner Gretchen Mathewson from Mount Sinai Hospital in New York City discuss why they view effective communication with patients as critical to developing optimal treatment plans. But effective communication is not without obstacles.

They comment that cognitive decline, varying degrees of health literacy, and language barriers can factor into patient understanding of treatment options. Cultural considerations can play a role in the way patients prefer to manage their disease. Yet, the Mount Sinai colleagues maintain that joint decision-making that directly involves the patient and the patient's family can lead to improved outcomes.

They discuss ways to build effective communication with patients, starting with the principle to hear what they are saying.


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