Iranian specialists’ approach to treatment escalation in multiple sclerosis patients with cognitive impairment
نویسندگان
1 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
4 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
5 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
6 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
7 Department of Neurology, Booalicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
8 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
9 Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
10 Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
11 Department of Neurology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
12 Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
13 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
14 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
15 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
16 Department of Neurology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
17 Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
18 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
19 Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
20 Center for Clinical Research and Development, Ghaem International Hospital, Rasht, Iran
21 Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
22 Department of Neurology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran
23 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
24 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
doi
10.18502/cjn.v22i1.12610چکیده
Background: People with multiple sclerosis (MS) and their physicians recognize cognitive retention as an important desired outcome of disease-modifying therapies (DMTs). In this study, we attempted to gather the opinions of Iranian MS experts regarding the treatment approach toward clinical cases with different physical and cognitive conditions.Methods: Opinions of 20 MS specialists regarding the best approach to 6 case scenarios (with different clinical, cognitive, and imaging characteristics) were gathered via a form.Results: The estimated kappa of 0.16 [95% confidence interval (CI): 0.159-0.163; P < 0.001] suggested a poor degree of agreement on the treatment choice among the professionals.Conclusion: Although most specialists agreed with treatment escalation in cases with cognitive impairment, there was no general agreement. Furthermore, there was not enough clinical evidence in the literature to develop consensus guidelines on the matter.
