The Use of Digital and Remote Communication Technologies as a Tool for Multiple Sclerosis Management: Narrative Review

Abstract

Despite recent advances in multiple sclerosis (MS) care, many patients only infrequently access health care services, or are unable to access them easily, for reasons such as mobility restrictions, travel costs, consultation and treatment time constraints, and a lack of locally available MS expert services. Advances in mobile communications have led to the introduction of electronic health (eHealth) technologies, which are helping to improve both access to and the quality of health care services. As the Internet is now readily accessible through smart mobile devices, most people can take advantage of eHealth apps. The development of digital applications and remote communication technologies for patients with MS has increased rapidly in recent years. These apps are intended to complement traditional in-clinic approaches and can bring significant benefits to both patients with MS and health care providers (HCPs). For patients, such eHealth apps have been shown to improve outcomes and increase access to care, disease information, and support. These apps also help patients to participate actively in self-management, for example, by tracking adherence to treatment, changes in bladder and bowel habits, and activity and mood. For HCPs, MS eHealth solutions can simplify the multidisciplinary approaches needed to tailor MS management strategies to individual patients; facilitate remote monitoring of patient symptoms, adverse events, and outcomes; enable the efficient use of limited resources and clinic time; and potentially allow more timely intervention than is possible with scheduled face-to-face visits. These benefits are important because MS is a long-term, multifaceted chronic condition that requires ongoing monitoring, assessment, and management. We identified in the literature 28 eHealth solutions for patients with MS that fall within the four categories of screening and assessment, disease monitoring and self-management, treatment and rehabilitation, and advice and education. We review each solution, focusing on any clinical evidence supporting their use from prospective trials (including ASSESS MS, Deprexis, MSdialog, and the Multiple Sclerosis Performance Test) and consider the opportunities, barriers to adoption, and potential pitfalls of eHealth technologies in routine health care.

Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey

“…It is possible that this is because patients are receiving PT in the community; although this is not reflected by the survey results. It can also be argued that a contemporary health system has several possibilities how to best support people with long term disabilities through the use of alternative approaches such as the education of patients to self-manage their own condition or the use of electronic health technologies [31]. Telerehabilitation approaches including interactive web-based programs, home-based systems for physical activity monitoring, or online communities [36], for instance, could monitor and motivate patients over time, whilst potentially improving the accessibility and quality of physiotherapy services [31].…”

The Effectiveness of Mindfulness-Based Intervention on Anxiety, Depression and Burden of Caregivers of Multiple Sclerosis Patients Through Web Conferencing

“…These applications aim at assisting conventional paraclinical methods and can have significant benefits for patients, their caregivers, and healthcare providers. These benefits are important because MS requires ongoing treatment and monitoring (Marziniak et al, 2018).…”

“…A telephone-based cognitive-behavioral therapy for family caregivers of people with dementia increased their mental and physical health as well as coping abilities (Wilz, Reder, Meichsner, & Soellner, 2017). Marziniak et al (2018) argued that digital applications and remote communication technology for patients with MS increased rapidly in recent years for reasons such as mobility restrictions, travel costs, consultation and treatment time constraints, and a lack of locally available MS expert services. Mahmoodi, Mohammad Khani, Ghobari Banab, and Bagheri (2016) reported that group cognitive-behavioral therapy could increase the use of compatible strategies for coping with stress and decrease the use of incompatible strategies.…”

The Effectiveness of Mindfulness-Based Internet Intervention on the Anxiety, Depression, and Fatigue of the Patients With Multiple Sclerosis

“…These applications aim at completing conventional inter-clinical methods and can have significant benefits for patients and healthcare providers. These benefits are essential because MS requires ongoing treatment and monitoring (Marziniak et al, 2018).…”