INDIANAPOLIS—Self-reported monitoring through an automated telehealth mechanism can provide a valid assessment of disease-modifying therapy (DMT) adherence among patients with multiple sclerosis (MS), according to study findings reported at the 2015 CMSC Annual Meeting. Further, utilizing an automated electronic system reduces the time spent making phone calls and researching pharmacy refill records by healthcare providers, according to Jill R. Settle and her research colleagues. Ms. Settle is affiliated with the MS Center of Excellence at the Veterans Affairs Medical Center in Washington, DC.
DMTs for MS have been available for more than 20 years; however, adherence to DMT regimens is often poor. The most common reason cited by patients is forgetting to take their medications on the specific day they are to be administered. To address the issue of non-adherence, Ms. Settle and colleagues sought to establish the feasibility of implementing a home telehealth program to support and monitor MS medication adherence without increasing healthcare provider burden.
The researchers addressed the assessment of poor adherence using a comprehensive Home Automated Telemanagement system for MS (MS HAT). MS HAT is a home-based Internet module that supports patient self-management, patient–provider communication, and patient education.
For approximately six months, 30 study participants were randomized to either MS HAT or treatment as usual. All participants stored their interferon β-1a syringes in a clear syringe container and maintained a paper calendar of medication adherence. Pharmacy refill rates were also collected from medical records. Participants in the MS HAT study arm received text or e-mail reminders to administer their medication.
There were no significant differences in demographic variables between the two groups. Likewise, overall adherence did not differ between the two groups. MS HAT alert rates were negatively correlated with syringe counts. As alerts decreased, syringes collected increased. Syringe count was positively related to change in Morisky score for interferon β-1a. As self-reported adherence improved, the number of syringes collected also increased. Pharmacy refills were directly related to calendar reports of taking the medication and syringe counts. As pharmacy refills increased, so did calendar reports and syringes collected.
The strong correlation between self-report and objective measures of adherence suggests that the MS HAT system is effective and cost-efficient.