Multipl Skleroz hastalarında öz yönetim modülünün geliştirilmesi ve değerlendirilmesi

Abstract

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.