A Telehealth Intervention for Nutritional Counseling in Amyotrophic Lateral Sclerosis Patients

Abstract

Nutritional status is one of the most relevant prognostic factors in Amyotrophic Lateral Sclerosis (ALS), and close monitoring can help avoid severe weight loss over the disease course. We describe the impact of a Chatbot webapp on improving the communications between physicians, patients, and/or caregivers for dietary monitoring. We developed a chatbot that provides patients with a tool to register their meals through an intuitive and carefully designed conversational interface. Patients recorded their dietary intake twice weekly and received an adequate nutritional recommendation monthly. We monitored their functional and nutritional parameters. The data were compared with a control group followed up by standard counseling. We enrolled 26 patients. Regarding feasibility, 96% of participants completed the three-month follow-up, and 77% ended the six months. Regarding the change in weight in the Chatbot group, we observed a weight stabilization (F = 1.874, p-value: 0.310 for changes) over the telehealth compared to the control group (F = 1.710, p-value: 0.024 for changes). A telehealth approach for nutritional support is feasible and reproducible in an ALS setting: frequent monitoring turned out to help prevent further weight loss, allowing an early nutritional strategy adjustment.

Psychosocial interventions for people with amyotrophic lateral sclerosis and motor neuron disease and their caregivers: a scoping review

“…Denmark, Iran, Japan, Russia, Spain, and Uruguay each published one study. In terms of study design, one group pre-post design [ 8 , 22 , 23 , 25 , 29 , 32 ] and RCT [ 7 , 9 , 19 , 24 , 35 , 38 ] were the most common with six studies, followed by five qualitative studies [ 6 , 10 , 18 , 30 , 31 ] and four quasi-experimental studies [ 5 , 28 , 34 , 39 ], and three each for mixed methods [ 33 , 36 , 40 ] and case studies [ 26 , 27 , 37 ].…”

“…Most of the studies involved less than 50 participants, two studies [ 5 , 38 ] 50–100 participants, one study [ 9 ] had over 100 participants. Eleven studies [ 5 , 19 , 22 , 24 – 27 , 34 , 35 , 37 , 39 ] collected data from people with ALS/MND, six studies [ 8 , 30 – 33 , 40 ] from family members, and ten studies [ 6 , 7 , 9 , 10 , 18 , 23 , 28 , 29 , 36 , 38 ] from both persons with ALS/MND and also family members.…”

“…This was followed by behavior therapy, counseling, and social support interventions, each comprising 7, and psychotherapy interventions, totaling 6. Education-related interventions included programs such as providing information regarding disease [ 39 ], skill training [ 32 ], teaching coping skills and problem solving [ 33 ], and nutrition education and counseling [ 34 ]. Behavior therapy interventions encompassed programs like expressive disclosure exercise [ 24 ] and music therapy [ 19 , 22 , 36 ], while counseling interventions included dignity therapy [ 8 , 23 ] and supportive counseling [ 39 ].…”

“…The number of interventions provided to people with ALS/MND was 12 [ 19 , 22 , 24 – 29 , 34 , 35 , 37 , 39 ], while provided to family members was five [ 9 , 30 , 32 , 33 , 40 ], and including both persons with ALS/MND and family members was eight [ 5 – 8 , 10 , 18 , 23 , 38 ]. Eighteen interventions were provided individually and remaining interventions [ 6 , 10 , 18 , 30 , 32 , 33 , 40 ] were administered in a group setting.…”

“…Most interventions were conducted in face-to-face settings. The remaining interventions included two delivered online [ 38 , 40 ], one employing a blended approach (combining face-to-face contact and online modules) [ 9 ], and one utilizing a webapp-based chatbot [ 34 ]. Health professionals, such as psychologists, therapists, and nurses, predominantly led the majority of interventions.…”