Use of patient reported outcomes in multiple sclerosis clinical management: Scoping literature review.
Abstract
Background
Patient-reported outcomes (PROs) are collected in some multiple sclerosis (MS) care settings, yet their uses in MS clinical care are unclear.
Objectives
To determine how PROs are used in MS clinical care and gain insights into instruments, purposes, facilitators/barriers, and impact.
Methods
Scoping review of studies reporting PRO use in MS clinical practice (January 2012-June 2025) across seven electronic databases.
Results
Of 6797 records screened, 21 articles (10 countries; 43 instruments) met review criteria. Frequently assessed domains were health-related quality of life (48%), depression (43%), and fatigue (29%). Electronic collection predominated (57%), yet only 38% integrated PROs with electronic health records (EHRs). Purposes included program evaluation (33%), secondary analysis (24%), collection methods (19%), and quality improvement (14%). While 48% reported process or system-level changes, only 29% documented clinical actions triggered by PRO data. Facilitators included brief measures, delegation to non-physician staff, and EHR integration. Barriers included low physician review, lack of response protocols, and absent auditing.
Conclusions
Articles on PROs in MS care are sparse. No consistent uses and purposes were found. Advancing meaningful PRO use requires response protocols, actionable thresholds, clinician accountability, and routine auditing of PRO-guided decisions.