Abstract Details

Title The Traffic Light System reduces Therapeutic Inertia in MS Care: results from a RCT

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-096

Objective

Our aim was to determine the efficacy the traffic light system (TLS) educational intervention to reduce therapeutic inertia (TI) among neurologists who care for MS patients.

Background

TI is commonly observed in the management of cardiovascular diseases and multiple sclerosis (MS). The consequences of TI include poorer clinical outcomes, greater disability and diminished quality of life. There are no proven effective interventions to overcome TI.

Design/Methods

In this RCT, 90 neurologists who provide care to MS patients, were randomly assigned to the TLS intervention (n=45) or to the control group (n=45). The TLS educational intervention consisted labelled disease progression risk categories in a short, structured, single session of 5-7 min duration. Participants made therapeutic choices of 10 simulated case-scenarios that assessed TI. The primary outcome was a reduction in TI using a previously established TI score. The proportion of TI among participants was a secondary outcome measure. This trial is registered with ClinicalTrials.gov NCT03134794.

Results All participants completed the study and were included in the primary analysis. The univariate analysis showed lower TI in the TLS group (1.47, 95%CI 1.32-1.61) compared to controls (1.93; 95%CI 1.79-2.08) (p=0.001). Similarly, the TLS group had a lower prevalence of TI compared to controls (0.67, 95%CI 0.62-0.71 vs. 0.82, 95%CI 0.78-0.86; p=0.001). The multivariate analysis, adjusted for age, specialty, years of practice, and risk preference showed a significant reduction in TI for participants randomized to the TLS vs control group (β - 0.68, 95%CI:-1.24; -0.11). The benefits of the TLS was across all TI score categories (Figure). Similarly, for the secondary outcome there was a 70% reduction in TI after the TLS intervention compared to controls (OR 0.30; 95%CI 0.10-0.89).

Conclusions In neurologists who cared for MS patients, a short, simple, and innovative educational intervention reduced TI irrespective of age, expertise, and years of practice.

Authors/Disclosures
Gustavo Saposnik, MD (Director, Clinical Outcomes & Decision Neuroscience Research Centre) PRESENTER	Dr. Saposnik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Saposnik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NIHSS. The institution of Dr. Saposnik has received research support from Roche. The institution of Dr. Saposnik has received research support from Heart and Stroke Foundation of Canada.
	No disclosure on file
	No disclosure on file
Maria Saladino (Straub Clinic And Hospital Inc)	No disclosure on file
	No disclosure on file
Xavier Montalban, MD, PhD, FAAN (Vall Hebron University Hospital-Multiple Sclerosis Centre of Catalonia)	The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck/ EMD Serono. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Hoffmann-La Roche. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Actelion/ Janssen Pharmaceuticals. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BMS/ Celgene. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi/ Genzyme. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BIAL PD. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PeerVoice. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Samsung Biosys. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas BioPharma. Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Actelion/ Janssen Pharmaceuticals. Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS/ Celgene. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck/ EMD Serono. Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffmann-La Roche. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic Therapeutics. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viatris/ Mylan. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. The institution of Dr. Montalban has received research support from Biogen. The institution of Dr. Montalban has received research support from Hoffmann-La Roche. The institution of Dr. Montalban has received research support from Sanofi/ Genzyme. The institution of Dr. Montalban has received research support from Merck/ EMD Serono. The institution of Dr. Montalban has received research support from Novartis. The institution of Dr. Montalban has received research support from Teva Pharmaceuticals. The institution of Dr. Montalban has received research support from Actelion/ Janssen Pharmaceuticals. The institution of Dr. Montalban has received research support from BMS/ Celgene.
	No disclosure on file
	No disclosure on file

��ɫ��

��ɫ��