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 Sinnige,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<sup>17

1</sup>Department of Community and Occupational Medicine, University Medical Center Groningen, University Groningen, Groningen, ²MS4 Research Institute, Nijmegen, ³Multiple Sclerosis Centre Leeuwarden, Medical Centre Leeuwarden, Leeuwarden, ⁴Department of Neurology, Medical Centre Alkmaar, Alkmaar, ⁵Department of Neurology, Groene Hart Hospital, Gouda, ⁶Department of Neurology, Canisius Wilhelmina Hospital, Nijmegen, ⁷Department of Neurology, Slingeland Hospital, Doetinchem, ⁸Department of Neurology, Zuwe Hofpoort Hospital, Woerden, ⁹Multiple Sclerosis Centre, Westfries Gasthuis, Hoorn, ¹⁰Department of Neurology, Ziekenhuisgroep Twente, Almelo-Hengelo, ¹¹Multiple Sclerosis Centre Midden Brabant, St Elisabeth Hospital, ¹²Multiple Sclerosis Centre Midden Brabant, Tweesteden Hospital, Tilburg, ¹³Department of Neurology, Reinier de Graaf Gasthuis, Delft, ¹⁴Department of Neurology, Viecuri Medical Centre, Venlo-Venray, ¹⁵Multiple Sclerosis Centre, Amphia Hospital, Breda, ¹⁶Department for Health Evidence, Radboud University Nijmegen Medical Centre, Nijmegen, ¹⁷Curavista 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 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).
Conclusion: 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.

Keywords: multiple sclerosis, self-management, web-based, care, multidisciplinary, patient-reported outcome

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.