Training physicians in providing complex information to patients with multiple sclerosis: A randomised controlled trial

Abstract

Objective To evaluate the effect of a specific communication training for neurologists on how to provide complex information about treatment options to patients with multiple sclerosis (MS). Design Single-centre, single-blind, randomised controlled trial. Setting One university hospital in Norway. Participants Thirty-four patients with early-stage MS. Intervention A 3-hour training for neurologists on how to provide complex information about MS escalation therapy. Main outcome measures Patient recall rate, measured with a reliable counting system of provided and recalled information about drugs. Secondary outcome measures Number of information units provided by the physicians. Effects on patient involvement through questionnaires. Methods Patients with MS were instructed to imagine a disease development and were randomised and blinded to meet a physician to receive information on escalation therapy, before or after the physician had participated in a 3-hour training on how to provide complex information. Consultations and immediate patient recall interviews were video-recorded and transcribed verbatim. Results Patient recall rate was 0.37 (SD=0.10) pre-intervention and 0.39 (SD=0.10) post-intervention. The effect of the intervention on recall rate predicted with a general linear model covariate was not significant (coefficient parameter 0.07 (SE 0.04, 95% CI (-0.01 to 0.15)), p=0.099). The physicians tended to provide significantly fewer information units after the training, with an average of 91.0 (SD=30.3) pre-intervention and 76.5 (SD=17.4) post-intervention; coefficient parameter -0.09 (SE 0.02, 95% CI (-0.13 to -0.05)), p<0.001. There was a significant negative association between the amount of provided information and the recall rate (coefficient parameter -0.29 (SE 0.05, 95% CI (-0.39 to -0.18)), p<0.001). We found no significant effects on patient involvement using the Control Preference Scale, Collaborate or Four Habits Patient Questionnaire. Conclusion A brief course for physicians on providing complex information reduced the amount of information provided, but did not improve patient recall rate. Trial registration number ISRCTN42739508.