SX04
Piloting a Mobile Platform in Multiple Sclerosis Patients Taking Oral Disease-Modifying Therapies
One of the current major challenges in multiple sclerosis (MS) care is the accurate monitoring of patient symptoms and status because annual or biannual clinic visits provide only limited information. There is increasing interest regarding “real-time” data collection platforms, such as smartphones, as they provide the opportunity to collect more frequent information.
Objectives:
To investigate the feasibility of a mobile application to collect clinical data from patients with MS and to examine the impact of mobile pop-up reminder on oral disease-modifying therapies (DMTs) adherence.
Methods:
A mobile platform that was previously used in epilepsy research was tailored for use in MS patients. A total of 60 MS patients (77% females, baseline mean age 41.3±10.1) taking or starting either teriflunomide (7%), fingolimod (58%), or dimethyl fumarate (35%) were recruited from the Partners MS Center, Brigham and Women’s Hospital. Subjects were randomized 1:1 to receive medication reminders on their mobile devices or no medication reminders and followed for 6 months. Subjects saved any missed pills and were asked to bring missed pills to the follow-up visit. During the 6-month period, subjects also completed items related to quality of life (QOL), mood, fatigue, cognition, and MS-specific symptoms on their mobile device. In particular, subjects rated their QOL daily on a 1-10 scale and every 8 days answered questions related to mood, fatigue, cognition, and MS symptoms using their mobile device. The impact of medication reminders on the proportion of subjects who missed no pills was assessed using a chi-squared test.
Results:
Out of the 60 participants recruited, 50 completed this 6-month prospective study (83.3%; 95% CI: 0.4,6.5). Over 80% of subjects completed the daily QOL item for at least 120 days during the study period, and 8% of subjects completed the daily QOL for all days. Pill count method (pills brought in vs self-reported, p=0.38), binary pill count (≤4 pills vs >4 pills, p=0.45; 95% CI:0.3,12.3) and numeric pill count (range 0-35, p=0.22; 95% CI:0.9,1.3) showed no significant differences between those randomized to receiving the daily pill reminder.
Conclusions:
Our study demonstrates that a mobile application is a feasible and acceptable intervention for MS patients.
Funding:
We would like to thank the Consortium of Multiple Sclerosis Centers for their support with this project.