The interactive web-based program MSmonitor for self-management and multidisciplinary care in multiple sclerosis: concept, content, and pilot results

• Published in: Patient preference and adherence Vol. 9; no. Issue 1; pp. 1741 - 1750
• Main Authors: Jongen, Peter Joseph, Sinnige, Ludovicus G, van Geel, Björn M, Verheul, Freek, Verhagen, Wim I, van der Kruijk, Ruud A, Haverkamp, Reinoud, Schrijver, Hans M, Baart, J Coby, Visser, Leo H, Arnoldus, Edo P, Gilhuis, H Jacobus, Pop, Paul, Booy, Monique, Lemmens, Wim, Donders, Rogier, Kool, Anton, van Noort, Esther
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2015; Dove Medical Press
• Subjects: Analysis; care; Care and treatment; multidisciplinary; Multiple sclerosis; Original Research; Patient compliance; patient-reported outcome; Self-care, Health; self-management; web-based; Netherlands; patient-reported outcome; multidisciplinary; self-management; multiple sclerosis; care; web-based
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S93783

There is a growing need to offer persons with multiple sclerosis (PwMS) possibilities for self-management and to integrate multidisciplinary health data. In 2009-2014 we developed a patient-reported outcome based, interactive, web-based program (MSmonitor) for (self-)monitoring, self-management and integrated, multidisciplinary care in MS. The notions underlying the MSmonitor concept and the program's elements are described. We analyze MSmonitor's role in the self-management of fatigue by retrospective comparison of fatigue and health-related quality of life (HRQoL) before and after usage of specific elements of MSmonitor, and by a correlative analysis between frequency of usage and fatigue change. After a step-wise development the program comprises six validated questionnaires: Multiple Sclerosis Impact Profile, Modified Fatigue Impact Scale-5 items (MFIS-5), Hospital Anxiety and Depression Scale, Multiple Sclerosis Quality of Life-54 items, and the 8-item Leeds Multiple Sclerosis Quality of Life (LMSQoL) questionnaires; two inventories: Medication and Adherence Inventory, Miction Inventory; two diaries: Activities Diary, Miction Diary; and two functionalities: e-consult and personal e-logbook. The program is now used in 17 hospitals by 581 PwMS and their neurologists, MS nurses, physical therapists, rehabilitative doctors, continence nurses, and family doctors. Those PwMS (N=105) who used the LMSQoL and MFIS-5 questionnaires at least twice in a period of up to 6 months, showed improved HRQoL (P<0.026). In the subgroup (N=56) who had also used the Activities Diary twice or more, the frequency of diary usage correlated modestly with the degree of fatigue improvement (r=0.292; P=0.028). MSmonitor is an interactive web-based program for self-management and integrated care in PwMS. Pilot data suggest that the repeated use of the short MFIS-5 and LMSQoL questionnaires is associated with an increase in HRQoL, and that a repeated use of the Activities Diary might contribute to the self-management of fatigue.