Cognitive assessment in multiple sclerosis clinical care: A qualitative evaluation of stakeholder perceptions and preferences

Elwick, Hannah; Smith, Laura; Mhizha-Murira, Jacqueline R; Topcu, Gogem; Leighton, Paul; Drummond, Avril; Evangelou, Nikos; Das Nair, Roshan

Abstract

There is a growing consensus that cognitive assessments should form part of routine clinical care in Multiple Sclerosis (MS). However, what remains unclear is which assessments are preferred by “stakeholders” (including people with MS, family members, charity volunteers, clinicians, and healthcare commissioners), in which contexts, and in which formats. Therefore, the aim of this study was to collect and synthesize stakeholders’ perceptions of the assessments that are acceptable and feasible for routine administration in the UK healthcare system. We interviewed 44 stakeholders and held one focus group (n = 5). We asked stakeholders about their experience with cognitive impairment and assessment and their views on how cognitive assessment could be implemented within routine clinical care. Using framework analysis, we summarized three themes: the current cognitive screening situation; the suitability of commonly used assessments; and feasibility aspects, including modality and location of testing. All participants acknowledged that cognitive impairment could have a significant impact on the quality of life, but that assessment and monitoring are not routinely performed in clinics. Barriers and enablers were described, and most participants reported that brief, routine screening with tests such as symbol substitution was acceptable. Electronic, self-administration of cognitive screening would be beneficial in minimizing clinic attendance and staff time.

Citation

Elwick, H., Smith, L., Mhizha-Murira, J. R., Topcu, G., Leighton, P., Drummond, A., Evangelou, N., & Das Nair, R. (2022). Cognitive assessment in multiple sclerosis clinical care: A qualitative evaluation of stakeholder perceptions and preferences. Neuropsychological Rehabilitation, 32(7), 1456-1474. https://doi.org/10.1080/09602011.2021.1899942

• Journal Article Type: Article
• Acceptance Date: Mar 3, 2021
• Online Publication Date: May 3, 2021
• Publication Date: 2022
• Deposit Date: Mar 5, 2021
• Publicly Available Date: May 4, 2022
• Journal: Neuropsychological Rehabilitation
• Print ISSN: 0960-2011
• Electronic ISSN: 1464-0694
• Publisher: Routledge
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 7
• Pages: 1456-1474
• DOI: https://doi.org/10.1080/09602011.2021.1899942
• Keywords: Applied Psychology; Rehabilitation; Arts and Humanities (miscellaneous); Neuropsychology and Physiological Psychology
• Public URL: https://nottingham-repository.worktribe.com/output/5368615
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/09602011.2021.1899942
• Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Neuropsychological Rehabilitation on 3/05/2021, available online: https://www.tandfonline.com/doi/full/10.1080/09602011.2021.1899942.