To determine the influence of patients’ factors associated with unwillingness to seek more effective disease modifying therapies (status quo) in multiple sclerosis (MS).

Recent studies showed the role of patients’ functional status in shared therapeutic decisions.  However, limited information is available regarding therapeutic status quo phenomenon.

A multicenter, non-interventional study involving patients with relapsing-remitting MS was conducted (PERCEPTIONS-MS). Participants answered questions regarding demographic data, risk preferences, and management of eight simulated MS case-scenarios. The SymptoMScreen questionnaire was used to assess the perception of symptom severity from the patients´ perspective in twelve neurologic domains. Status quo (SQ) was defined as patients’ preference to maintain the current treatment when there was clinical and radiological evidence of disease activity. A SQ score was defined as the number of case-scenarios that met the status quo criteria over the total number of presented (score ranging from 0-10). Mixed linear models adjusting for clustering assessed the association of candidate predictors with the outcome of interest.

A total of 211 patients completed the study.  Mean SQ score was 2.82 ± 2.0. Thirty-five percent (N=74) of participants were unwilling to switch therapy in more than half of the presented scenarios. The most common factor associated with SQ was SymptoMScreen score (Coef 0.011; 95% CI 0.005-0.017) after adjustment for age, gender, education, living status, disease duration, number of relapses, EDSS score, number of previous MS treatments, and mood. Mixed logistic regression analysis showed that higher SymptoMScreen scores was the single independent factor associated with SQ (OR 1.06; 95% CI 1.02-1.09).

Unwillingness to pursue more effective treatments is a common phenomenon driven by patients’ perception of their individual status. Further studies are necessary to explore if a negative outlook and sense of helplessness toward the future (hopelessness) could be involved.