The purpose of this pilot trial is to provide preliminary evidence of the effectiveness of a
brief behavioral intervention using telemedicine home monitoring to help individuals with
multiple sclerosis adhere to medications that slow disease progression.
There is increasing recognition that coordinated approaches to disease management improve
medication adherence. Intervention in chronic illness may be viewed as a multidisciplinary
and collaborative process based upon behavioral principles, including the idea that illness
management skills are learned and behavior is self-directed, motivation and self-efficacy
can affect self care, monitoring and responding to changes in physical and mental health
improves adaptation to illness, and the health care system can support or hinder self care.
Preliminary findings suggest that telemedicine home monitoring providing cues to medication
administration, brief evaluation of potential barriers (e.g., fatigue, cognition, side
effects), identification of areas for future education (e.g., additional injection
training), and an opportunity for feedback to providers (e.g., side effects) are well
tolerated and may improve self monitoring of chronic medical conditions.
The proposed study is a six-month, two group parallel-design, controlled trial to evaluate
feasibility and obtain effect size estimates for a behavioral intervention to improve
adherence to MS disease modifying therapy (DMT) using telemedicine home monitoring.
Monitoring will include brief weekly text-based prompting to complete a series of
approximately 10-15 questions regarding factors that are expected to affect adherence to
DMT. Areas of assessment will include the development of side effects (e.g., flu-like
symptoms), disease specific symptoms (e.g., fatigue), adherence expectation, and DMT
self-efficacy. MS clinic staff will examine responses to weekly home monitoring assessment.
They will provide telephone follow-up for medical advice, support, specific educational
materials, and referral for services if necessary. Potential services will also be informed
by Research Project 1, and will follow the general principle that they will be selected from
a standardized list (e.g., additional injection training, energy management strategies for
fatigue), but tailored to individual patient need based upon information obtained by home
Primary outcome measures to assess feasibility will be the percentage of eligible
participants who complete the study protocol, and comparisons between home monitoring
recipients and controls regarding the overall benefits of participation. Outcomes will be
assessed via monthly telephone calls.
- Must have Multiple Sclerosis and be on a disease modifying therapy
- Inability to participate in self-care