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The Relationship between Risk Attitude and Treatment Choice in Patients with Relapsing-Remitting Multiple Sclerosis

Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care

Karen M. Kuntz, ScD

Harvard Center for Risk Analysis, Department of Health Policy and Management, Harvard School of Public Health

Amit Bar-Or, MD, MSc

Department of Neurology and Neurosurgery, Montreal Neurological Institute and McGill University

Milton C. Weinstein, PhD

Harvard Center for Risk Analysis, Department of Health Policy and Management, Harvard School of Public Health

Background. Many patients with multiple sclerosis (MS) eligible for β-interferons or glatiramer acetate have chosen to forgo or discontinue treatment. The objective of this study was to evaluate risk attitude as a patient characteristic related to treatment choice for patients with MS. Methods. Sixty-two MS patients completed a survey on treatment history, risk preference, and socioeconomic and clinical variables. Multinomial logistic regression was used to assess the relationship between treatment choice and risk attitude. Risk attitude was measured using a standard gamble question on short-term health outcomes. Results. More risk-seeking patients were less likely to choose treatment compared with more risk-averse patients (P < 0.01). For patients who discontinued treatment, the explanatory variable of significance was severity of side effects (P < 0.05). Conclusions. Risk attitude is a patient characteristic related to treatment initiation in patients with MS. This could be an important factor to consider when identifying optimal treatment decisions for individual patients.

Key Words: risk attitude • treatment choice • adherence • compliance • multiple sclerosis

Medical Decision Making, Vol. 22, No. 6, 506-513 (2002)
DOI: 10.1177/0272989X02238299


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