{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:16:59Z","timestamp":1761920219488,"version":"3.41.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,2,15]],"date-time":"2017-02-15T00:00:00Z","timestamp":1487116800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Natalizumab, a monoclonal antibody directed against \u03b14 integrin, is a highly efficacious treatment commonly used in relapsing remitting multiple sclerosis. Natalizumab is associated with the potentially fatal, rare, demyelinating, opportunistic brain infection, progressive multifocal leukoencephalopathy (<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>). Prognosis and disability from<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>are determined by early diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Written tools are mandated in Australia and other prescribing countries with the aim to help patients understand the risks associated with treatment and ensure familiarity with the early symptoms of<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>. We aimed to assess if these tools achieve such an outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional survey was conducted using a convenience sample of multiple sclerosis patients prescribed natalizumab presenting to the infusion centre at a major tertiary hospital. Patients were offered a multi\u2010choice questionnaire to assess their knowledge on the treatment risks and surveillance requirements of their therapy. Three specific questions were highlighted by the researchers as crucial to patient understanding of<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>and defined as basic knowledge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 48 patients in our hospital was prescribed natalizumab; 37 responded. A total of 16 (43.2%) patients answered all three basic knowledge questions correctly. There was no difference in the ability to answer these questions based on length of treatment or co\u2010ownership knowledge between patients with base knowledge and without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Natalizumab is associated with an increased risk of PML. Early detection and treatment of<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>results in improved patient outcomes. Patient knowledge and co\u2010partnership in the utilisation of<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>risk tools is relevant in ensuring early detection. Our findings question the ability of currently sanctioned tools to inform patients of basic knowledge of<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>and their risk of developing<jats:styled-content style=\"fixed-case\">PML<\/jats:styled-content>. A future study with a repetitive education approach and repeating the questionnaire at multiple time points would be of interest.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13318","type":"journal-article","created":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T08:37:04Z","timestamp":1478767024000},"page":"194-199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Assessing understanding of individual risk and symptoms of progressive multifocal leukoencephalopathy in patients prescribed natalizumab for multiple sclerosis"],"prefix":"10.1111","volume":"47","author":[{"given":"Louise","family":"Rath","sequence":"first","affiliation":[{"name":"Neurology Department Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirosen","family":"Vijiaratnam","sequence":"additional","affiliation":[{"name":"Neurology Department Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Skibina","sequence":"additional","affiliation":[{"name":"Neurology Department Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,2,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107829"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2010.164"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511435105"},{"key":"e_1_2_6_5_1","first-page":"117","article-title":"Stratification and monitoring of natalizumab\u2010associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group","volume":"87","author":"McGuigan C","year":"2016","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"e_1_2_6_6_1","unstructured":"Biogen Australia Pty Ltd.Tysabri Australasian Prescribing Program (TAPP). [cited 2016 Jul 28]. Available from URL:http:\/\/tapp.com.au\/"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-014-1918-y"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.114"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24286"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31821a446b"},{"key":"e_1_2_6_11_1","first-page":"224","article-title":"Neuropsychological impairment in natalizumab\u2010associated progressive multifocal leukoencephalopathy: implications for early diagnosis","volume":"87","author":"Hoepner R","year":"2016","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70149-1"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70078-9"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djr318"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39246.581169.80"},{"key":"e_1_2_6_16_1","first-page":"1164","article-title":"Informed consent: Patient listens and read, but what information do they retain?","volume":"115","author":"Turner P","year":"2002","journal-title":"N Z Med J"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138364"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458512461967"},{"key":"e_1_2_6_19_1","first-page":"4520","article-title":"Emergency Department education improves patient knowledge of coronary artery disease risk factors but not the accuracy of their own risk perception","volume":"4","author":"Williams A","year":"2007","journal-title":"Prev Med"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2009.04.009"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.07.031"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21305"},{"key":"e_1_2_6_23_1","unstructured":"Biogen Idec Pty Ltd.Touch Tysabri Outreach: Unified Commitment to Health. [cited 2016 Mar 10]. Available from URL:http:\/\/www.touchprogram.com"},{"key":"e_1_2_6_24_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.37464\/2016.334.1596","article-title":"Health literacy, does it make a difference?","volume":"31","author":"Johnson A","year":"2014","journal-title":"Aust J Adv Nurs"},{"volume-title":"Health Literacy: Taking Action to Improve Safety and Quality","year":"2014","author":"Australian Commision on Safety and Quality in Health Care","key":"e_1_2_6_25_1"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13318","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13318","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13318","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T09:13:00Z","timestamp":1749719580000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.13318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1111\/imj.13318"],"URL":"https:\/\/doi.org\/10.1111\/imj.13318","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"type":"print","value":"1444-0903"},{"type":"electronic","value":"1445-5994"}],"subject":[],"published":{"date-parts":[[2017,2]]},"assertion":[{"value":"2016-08-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}