Multipl Skleroz hastalarında öz yönetim modülünün geliştirilmesi ve değerlendirilmesi
Özet
Appropriate treatment and symptom management in Multiple Sclerosis (MS) can
improve the quality of life in patients, limit the impact of disability, and ensure continuity of
patients’ social lives. International reports have revealed that self-management practices are
an approach that can be effective in reducing MS-related symptoms and can help patients to
manage the impacts of MS. The aim of this study is to improve self-management abilities of
patients through the developed module and to evaluate the effect of this module in short and
long terms. In addition, it is aimed to assess the effect of the Self-Management Module on the
change in engagement status of patients during treatment process, patient’s adherence and
satisfaction on provided care. This prospective, randomized controlled study was conducted
at Hacettepe University Hospitals Neurology Department between January 2020 and
November 2021. In this context, a 'Self-Management Module' was developed by collaboration
of clinical pharmacist-physician to contribute to the self-management skills of MS patients.
The concept of Self-Management Module was implemented in the study group, which
included the provision of information by a clinical pharmacist about disease and treatment in
addition to activities that improve medication adherence and encouraging patients to selfmonitoring.
After implementation of the module, it was determined that the increase in the
MS Self Management Scale of the patients in the study group (mean score at the first
interview: 90.2; last interview: 99.8) was higher than the patients in the control group (mean
at the first interview: 90.8; last interview: 91.9) (p<0.001). In addition, the Self-Management
Module has been shown to improve patients' medication adherence, perception of care and
patient participation. The patient’s self-management is found to be significantly affected by
age (B=-0.11), education (B=-2.83), medication adherence (B=25.29), perception of chronic
illness (B=0.47), and category of patient participation (blackout group B=-9.48). It is thought
that improving patient self-management will strengthen the relationship between patient and
healthcare professionals and contribute patients being take an active role in the shared
decision-making process in disease management.
