title: Monitoring medication adherence in multiple sclerosis using a novel web-based tool: A pilot study.
abstract: Monitoring medication adherence in multiple sclerosis (MS) can be time consuming and expensive; however, non-adherence is common and is very costly in terms of lost therapeutic benefit and unused medications. To address this problem, we employed a web-based system to monitor and potentially modify medication adherence. Participants (n = 30) were randomized either to routine care or to the MS Home Automated Telehealth (MS HAT) system. Weekly interferon beta-1a intramuscular (INFbeta-1a IM) injections and daily vitamin D adherence were tracked over a six-month period using multiple modalities: self-reported adherence, calendar diaries, pharmacy refill rates, blood serum levels, and MS HAT alerts. Weekly INFbeta-1a IM adherence was highly correlated across measures; however, vitamin D adherence was not as consistent. Healthcare providers were able to efficiently monitor adherence in a patient-centered way by using the MS HAT system to monitor adherence rather than employing chart reviews and phone calls. In addition, patients with more preserved cognitive function appeared to benefit more from use of the MS HAT system than those with cognitive impairment. While further research is needed to understand the differential effects of MS HAT on specific medications and for different individuals, it is a promising tool for monitoring medication adherence in patients with MS.
authors.affiliation: Multiple Sclerosis Centers of Excellence, Washington, DC, USA Baltimore Veterans Affairs Medical Centers, USA jill.settle@va.gov.
authors.forename: Jill R
authors.initials: JR
authors.lastname: Settle
authors.affiliation: Multiple Sclerosis Centers of Excellence, Washington, DC, USA Baltimore Veterans Affairs Medical Centers, USA.
authors.forename: Heidi W
authors.initials: HW
authors.lastname: Maloni
authors.affiliation: Chronic Disease Informatics Program, Johns Hopkins University School of Medicine, USA.
authors.forename: McKenzie
authors.initials: M
authors.lastname: Bedra
authors.affiliation: Chronic Disease Informatics Program, Johns Hopkins University School of Medicine, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Finkelstein
authors.affiliation: Multiple Sclerosis Centers of Excellence, Washington, DC, USA Baltimore Veterans Affairs Medical Centers, USA Department of Epidemiology, University of Maryland School of Medicine, USA.
authors.forename: Min
authors.initials: M
authors.lastname: Zhan
authors.affiliation: Multiple Sclerosis Centers of Excellence, Washington, DC, USA Baltimore Veterans Affairs Medical Centers, USA Neurology Department, Georgetown University School of Medicine, USA.
authors.forename: Mitchell T
authors.initials: MT
authors.lastname: Wallin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D000068556:Interferon beta-1a / Q000008:administration & dosage / Q000627:therapeutic use; D020407:Internet; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000523:psychology; D010865:Pilot Projects; D017216:Telemedicine / Q000379:methods*; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D014807:Vitamin D; D000068556:Interferon beta-1a
keywords: Multiple sclerosis; medication adherence; monitoring; telehealth