Web-Based Self-Management for Patients with Multiple Sclerosis: A Practical, Randomized Trial
- 1 January 2011
- journal article
- research article
- Published by Mary Ann Liebert Inc in Telemedicine and e-Health
- Vol. 17 (1), 5-13
- https://doi.org/10.1089/tmj.2010.0133
Abstract
Objective: No studies have addressed the use of electronic personal health records (e-PHRs) for self-management in complex neurological disorders. We assessed and tested an Internet-based self-management system that utilized the e-PHR and determined its impact on self-assessed well-being, clinician-assessed well-being, and healthcare utilization in patients with multiple sclerosis (MS). Materials and Methods: Subjects were randomized to usual care (a secure Web-based messaging system) or active intervention, which included secure messaging, self-monitoring, self-management of MS symptoms, and communication about upcoming clinic visits. Computers and Internet access were provided. Subjects were included if they had MS, lived within the county or region surrounding our MS center, had at least two appointments at our center in the previous 12 months, and demonstrated basic typing and computer skills. Study duration was 12 months. Results: Of 220 subjects completing informed consent, 206 met the inclusion criteria. At the study's end, 83 subjects remained in the usual care group and 84 in the enhanced care group. Both groups used the available system components. The groups did not significantly differ on the primary endpoints or healthcare utilization. Conclusions: Self-management support is an emerging aspect of chronic care management. We established the feasibility of conducting a randomized, controlled trial using e-PHRs for patient self-management. We did not find that e-PHR–enabled self-management augmented multidisciplinary MS center-based care, possibly because the differences between interventions were not great enough.Keywords
This publication has 20 references indexed in Scilit:
- Using an Automated Recruitment Process to Generate an Unbiased Study Sample of Multiple Sclerosis PatientsTelemedicine and e-Health, 2010
- A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus: 5 Year Results of the IDEATel StudyJournal of the American Medical Informatics Association, 2009
- Acceptance of home telemanagement is high in patients with multiple sclerosis.2007
- Internet-Based Chronic Disease Self-ManagementMedical Care, 2006
- Change in clinician-assessed measures of multiple sclerosis and subject-reported quality of life: results from the IMPACT studyMultiple Sclerosis Journal, 2006
- Practical Clinical TrialsJAMA, 2003
- The Multiple Sclerosis Functional Composite: a new clinical outcome measure for multiple sclerosis trialsMultiple Sclerosis Journal, 2002
- EQ-SD: a measure of health status from the EuroQol GroupAnnals of Medicine, 2001
- Measuring self-efficacy in people with multiple scleoris: a validation studyArchives Of Physical Medicine and Rehabilitation, 1996
- The Sickness Impact Profile: Development and Final Revision of a Health Status MeasureMedical Care, 1981