The aim of this study was to assess relapsing-remitting multiple sclerosis (RRMS) patients’ preferred role in making treatment decisions.

A multicenter, non-interventional study was conducted at 19 hospital-based MS care units in Spain. Adult patients with a diagnosis of RRMS (2017 revised McDonald criteria) and disease duration between 3 and 8 years were included. Patients´ preferred role in their closest treatment decision was measured using the Control Preference Scale (CPS). A battery of patient-reported and clinician-rated measures was administered. A multivariate logistic regression analysis was conducted.

A total of 198 patients were included. Mean age (SD) was 38.7 (8.5) years and 74.2% were female. Median disease duration (IQR) was 6.0 (4.0-7.0) years. Median EDSS score was 1.0 (0-2.0). Ninety-two patients (46.5%) adopted a collaborative attitude and preferred making the treatment decision jointly with the neurologist, 59 (29.8%) adopted a passive attitude and preferred the neurologist make the decision, and 47 (23.7%) showed active attitude preferring to make the decisions themselves. We found a higher perception of symptom severity (p=0.002), more fatigue (p=0.005), a lower physical quality of life (p<0.001), and a worse mental speed processing (p=0.002) among passive patients compared to active ones. The collaborative role was associated with age (OR=1.07, 95% CI 1.01, 1.13, p=0.010) in the multivariable analysis after adjustment for confounders. There was no association between patient’ role and disability, mood, anxiety, MS knowledge, risk-taking behavior, or self-management.

Although almost 50% of patients preferred a collaborative attitude in treatment decisions with their neurologists, one third preferred a passive approach. Adapting communication and participation strategies to the preferences of each RRMS patient may be crucial to improve the shared decision-making process.