"A qualitative study of multiple sclerosis specialists' experiences and perspectives in managing family planning in people with multiple sclerosis".

Family planning MS nurse Multiple sclerosis Neurologist Qualitative research

Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
24 Dec 2023
Historique:
received: 21 09 2023
revised: 02 11 2023
accepted: 22 12 2023
medline: 5 1 2024
pubmed: 5 1 2024
entrez: 4 1 2024
Statut: aheadofprint

Résumé

Managing multiple sclerosis (MS) in people of reproductive age can be challenging as treatment decisions often need to balance efficacy, safety to reproductive health and an understanding of reproductive intentions. There has been limited examination of how family planning (FP) is approached in people with MS (pwMS) in Australia. This study aimed to explore the experiences and perspectives of Australian MS clinical specialists on managing FP in the context of MS. We conducted one-on-one semi-structured interviews with nine neurologists and ten MS nurses across Australia who regularly provide care to pwMS of reproductive age. Interview topics examined current approaches to managing FP, availability of FP resources, and opportunities for improvement. Interview recordings were transcribed verbatim and analysed thematically. Two main themes emerged. First, 'inconsistent approaches in providing family planning', where neurologists and MS nurses recognised FP provision as essential but revealed differences in the content, timing and extent of FP discussions; conflicts between reproductive considerations and DMT prescriptions according to teratogenic risk; and variable implementation of interdisciplinary approaches. Second, 'barriers in providing family planning' emerged which included a lack of local information resources on FP, lack of contemporary data on safety of DMTs, and a range of patient and professional factors, including time constraints. MS clinical specialists saw FP as an essential part of the care of their patients and expressed a need for information and service provision consistency in order to improve FP and reproductive care to pwMS.

Sections du résumé

BACKGROUND BACKGROUND
Managing multiple sclerosis (MS) in people of reproductive age can be challenging as treatment decisions often need to balance efficacy, safety to reproductive health and an understanding of reproductive intentions. There has been limited examination of how family planning (FP) is approached in people with MS (pwMS) in Australia. This study aimed to explore the experiences and perspectives of Australian MS clinical specialists on managing FP in the context of MS.
METHODS METHODS
We conducted one-on-one semi-structured interviews with nine neurologists and ten MS nurses across Australia who regularly provide care to pwMS of reproductive age. Interview topics examined current approaches to managing FP, availability of FP resources, and opportunities for improvement. Interview recordings were transcribed verbatim and analysed thematically.
RESULTS RESULTS
Two main themes emerged. First, 'inconsistent approaches in providing family planning', where neurologists and MS nurses recognised FP provision as essential but revealed differences in the content, timing and extent of FP discussions; conflicts between reproductive considerations and DMT prescriptions according to teratogenic risk; and variable implementation of interdisciplinary approaches. Second, 'barriers in providing family planning' emerged which included a lack of local information resources on FP, lack of contemporary data on safety of DMTs, and a range of patient and professional factors, including time constraints.
CONCLUSION CONCLUSIONS
MS clinical specialists saw FP as an essential part of the care of their patients and expressed a need for information and service provision consistency in order to improve FP and reproductive care to pwMS.

Identifiants

pubmed: 38176286
pii: S2211-0348(23)00908-2
doi: 10.1016/j.msard.2023.105409
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105409

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors have nothing to declare.

Auteurs

A Fragkoudi (A)

Adelaide Medical School, University of Adelaide, Adelaide, Australia; Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia. Electronic address: anna.fragkoudi@adelaide.edu.au.

A R Rumbold (AR)

Adelaide Medical School, University of Adelaide, Adelaide, Australia; Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.

T Burke (T)

School of Nursing, University of Notre Dame, Sydney, Australia.

L E Grzeskowiak (LE)

Adelaide Medical School, University of Adelaide, Adelaide, Australia; Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia; College of Medicine and Public Health, Flinders University, Adelaide, Australia.

Classifications MeSH