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The web trawl feature examines some of the web sites quoted in articles appearing in the journal. This month’s column focuses on a single site for patients with multiple sclerosis.
http://www.msdecisions.org.uk This site has been designed as a guide for multiple sclerosis patients who are being considered for treatment with a disease modifying drug (either beta interferon or glatiramer acetate). The site’s aims, which are clearly stated on the home page, are to help patients decide whether to start on a course of treatment with one of these drugs, and, if they do go ahead, to help them decide which of the currently available drugs would be the best choice for them. A disclaimer reinforces that the site is not a substitute for medical advice, and that it is provided so that patients may be helped to make an informed choice regarding their future treatment; a decision that needs to be made in partnership with the team caring for them. From the home page, the user may access pages dealing with the disease itself, the treatments available, detailed information about disease modifying drugs, a decision making tool, and further reading. The pages are intended to be worked through in order (45 minutes is the minimum time recommended). The first section provides detailed background information on the different types of multiple sclerosis. It is clearly written and illustrated, with all medical terms explained. The next section outlines the treatment options available, and then continues with an in depth discussion of disease modifying drugs (DMDs), and the eligibility criteria for their use. Advice is also given for patients who are deemed ineligible for DMD treatment, so that they are able to consider other options. Following on from this, is a section detailing factors patients will need to consider if they start treatment with DMD, for example, will they be able to cope with injecting the drug themselves. Videos showing the injection process are provided, along with brief interviews with a number of patients who demonstrate different clinical scenarios. Next is the decision making tool, which consists of a number of highly subjective questions for the patient to answer on screen, at the end of which they are provided with a table showing the pros and cons of each treatment option. This table is very detailed, with colour coding to indicate the advantages and disadvantages of each DMD (and, indeed of having no treatment). This page could potentially be very confusing, but the user is able to hide some of the information, if there is an area they wish to concentrate on. The final section provides details of, and links to, other organisations that patients may find useful. The web site has been created with funding from the Department of Health, and was last updated on 31 January 2005, so the information provided is current. Patients with multiple sclerosis are likely to find it of great value in terms of the information provided, and indeed anyone who is not a neurologist and wishes a clear update on DMDs may also find the site of use. I would have no hesitation in recommending it.