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Patient Preference and Adherence 2015:9 1741–1750
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Open Access Full Text Article
http://dx.doi.org/10.2147/PPA.S93783
The interactive web-based program Msmonitor
for self-management and multidisciplinary care
in multiple sclerosis: concept, content, and pilot
results
Peter Joseph Jongen,
1,2
ludovicus
g sinni ge,
3
Björn M van geel,
4
Freek Verheul,
5
Wim l Verhagen,
6
ruud A van der Kruijk,
7
reinoud
haverkamp,
8
hans M schrijver,
9
J coby Baart,
10
leo h Visser,
11
edo P Arnoldus,
12
h Jacobus
gilhuis,
13
Paul Pop,
14
Monique
Booy,
15
Wim lemmens,
16
rogier
Donders,
16
Anton Kool,
17
esther
van noort
17
1
Department of community and
Occupational Medicine, University
Medical center groningen, University
groningen, groningen,
2
Ms4 research
institute, nijmegen,
3
Multiple sclerosis
centre leeuwarden, Medi cal centre
leeuwarden, leeuwarden,
4
Department
of neurology, Medical centre Alkmaar,
Alkmaar,
5
Department of neurology,
groene hart hospital, gouda,
6
Department
of neurology, canisius Wilhelmina hospital,
nijmegen,
7
Department of neurology,
slingeland hospital, Doetinchem,
8
Department of neurology, Zuwe
hofpoort hospital, Woerden,
9
Multiple
sclerosis centre, Westfries gasthuis,
hoorn,
10
Department of neurology,
Ziekenhuisgroep Twente, Almelo-hengelo,
11
Multiple sclerosis centre Midden Brabant,
st eli sabeth hospital,
12
Multiple sclerosis
centre Midden Brabant, Tweesteden
hospital, Tilburg,
13
Department of
neurology, reinier de graaf gasthuis,
Delft,
14
Department of neurology, Viecuri
Medical centre, Venlo-Venray,
15
Multiple
sclerosis centre, Amphia hospital, Breda,
16
Department for health evidence, radboud
University nijmegen Medical centre,
nijmegen,
17
curavista bv, geertruidenberg,
the netherlands
Background: 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.
Methods: 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.
Results: 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 question-
naires 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).
Conclusion: MSmonitor is an interactive web-based program for self-management and inte-
grated 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.
Keywords: multiple sclerosis, self-management, web-based, care, multidisciplinary, patient-
reported outcome
Introduction
Multiple sclerosis (MS) is a chronic inflammatory and degenerative disease of the central
nervous system. In approximately 80% of the persons with multiple sclerosis (PwMS) the
first clinical phase is characterized by recurrent episodes of new or worsening symptoms
(relapses), which are typically followed by complete or partial remissions: relapsing
remitting MS (RRMS). Anti-inflammatory immune-modulating or immune-suppressing
drugs may substantially reduce the frequency and severity of relapses, and thus modify the
correspondence: Peter Joseph Jongen
Department of community and
Occupational Medicine, University Medical
center groningen, University groningen,
Antonius Deusinglaan 1, 9713 AV groningen,
the netherlands
email p.j.h.jongen@rug.nl
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