Kirsty: How much choice do patients have in their treatment, or is it up to their neurologist?
Dr Belinda Weller, Neurologist: Well, I like to involve my patients as much as I possibly can in making the decision, because I think if a person’s been involved in making the decisions about their treatment, they’re more likely to continue to take it and to feel positive about taking it, rather than if you impose it on them. But I guess there are some situations where I do have to give people guidance, so some people just don’t want treatment at all, when I have to say look, I really do think that you’d benefit from it. And similarly if people have got very active MS they probably need to be guided to one of the more efficacious treatments that they sometimes have more risk. So what I tend to do is to guide people with MS in the direction of perhaps a couple of choices and I like to give them the information about them and sit with them and have a chat, let them go away and have a think about it, and then come back either to me or the MS nurses with a decision. It’s pretty unusual that somebody chooses something that I’m not entirely happy with.
Kirsty: What advice would you give to someone who you’ve heard has not really been given much of a choice and has been told, well you have to go on this?
Dr Belinda Weller: Yeah. It still happens in some places and I think it would depend on that person, how they were doing. So if they’re on a treatment and it wasn’t their ideal choice but they were doing well and they hadn’t had any relapses, I would say, well look, it’s working for you, try and stick with it. But if the treatment’s not working, either because the person’s having relapses or getting worse, or if they just can’t tolerate the side effects, then I think they have to ask for another opinion or find another neurologist. That’s probably my approach. Having said that, I think most of the neurologists around the place themselves are fairly good and open. Sometimes we don’t have a lot of choice ourself, it often comes down to licensing indications, what we’re allowed to use.
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