title: A prospective web-based patient-centred interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in The Netherlands: the Dutch Multiple Sclerosis Study protocol.
abstract: BACKGROUND
  In the past two decades the widespread use of disease modifying drugs with moderate to strong efficacy has changed the natural course of multiple sclerosis (MS). Health care professionals, researchers, patient organizations and health authorities are in need of recent information about the objectified and subjective long-term clinical outcomes in MS patients. Such information is scarce.
  
  
  METHODS
  We started a prospective, web-based, patient-centred, interactive study of long-term disabilities, disabilities perception and health-related quality of life (HRQoL) in MS patients in The Netherlands (Dutch Multiple Sclerosis Study). The study has an on online patient-driven inclusion and online acquisition of patient-reported outcomes (PROs). At six-months intervals participants complete the Multiple Sclerosis Impact Profile (MSIP) (disabilities and disabilities perception in seven domains and four symptoms), the Multiple Sclerosis Quality of Life-54 items (MSQoL-54), the Modified Fatigue Impact Scale-5 items (MFIS-5) and the Leeds Multiple Sclerosis Quality of Life-8 items (LMSQoL) questionnaires, and a Medication and Adherence Inventory. Every three years the Expanded Disability Status Scale (EDSS) score is assessed by phone. The monthly completion of the MFIS-5, LMSQoL and Medication and Adherence Inventory is optional. Completed questionnaires and inventories, and automatically generated scores are made available online to patients for self-monitoring and self-management purposes, and to authorized health care professionals for the evaluation of disease activity and of the effectiveness of treatments. Study duration is planned to be 15 years. Results will be analyzed periodically using means and standard deviations for continuous variables, and frequencies for categorical variables. Relations between time points, variables, patient and treatment characteristics will be evaluated in random effects repeated measures models.
  
  
  CONCLUSIONS
  The Dutch Multiple Sclerosis Study is characterized by online patient-driven inclusion; online data acquisition; the use of PROs; the optional monthly completion of short questionnaires; the interactive use of personal study data by patients and authorized health care professionals for self-monitoring, self-management and multidisciplinary care; the expected representativeness of the study sample; and a long-term time horizon. The study will provide valuable data on long-term disabilities, disabilities perceptions and HRQoL in MS patients in The Netherlands.
authors.affiliation: Department of Community & Occupational Medicine, University Medical Centre Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. p.j.h.jongen@rug.nl.|MS4 Research Institute, Ubbergseweg 34, 6522 KJ, Nijmegen, The Netherlands. p.j.h.jongen@rug.nl.
authors.forename: Peter Joseph
authors.initials: PJ
authors.lastname: Jongen
authors.affiliation: MH-Advies & organisatiebureau, IJselstraat 81, 9406 TR, Assen, The Netherlands. m.a.p.heerings@gmail.com.|National MS Foundation The Netherlands, Mathenesserlaan 378, 3023 HB, Rotterdam, The Netherlands. m.a.p.heerings@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Heerings
authors.affiliation: Department for Health Evidence, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Wim.Lemmens@radboudumc.nl.
authors.forename: Wim A
authors.initials: WA
authors.lastname: Lemmens
authors.affiliation: Department for Health Evidence, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Rogier.Donders@radboudumc.nl.
authors.forename: Rogier
authors.initials: R
authors.lastname: Donders
authors.affiliation: National MS Foundation The Netherlands, Mathenesserlaan 378, 3023 HB, Rotterdam, The Netherlands. anneke@nationaalmsfonds.nl.
authors.forename: Anneke
authors.initials: A
authors.lastname: van der Zande
authors.affiliation: Curavista bv, Markt 9, 4931 BR, Geertruidenberg, The Netherlands. Esther.vanNoort@curavista.nl.
authors.forename: Esther
authors.initials: E
authors.lastname: van Noort
authors.affiliation: Curavista bv, Markt 9, 4931 BR, Geertruidenberg, The Netherlands. anton.kool@curavista.nl.
authors.forename: Anton
authors.initials: A
authors.lastname: Kool
mesh_terms: D000203:Activities of Daily Living; D001294:Attitude to Health; D003711:Demyelinating Diseases / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D018450:Disease Progression; D006304:Health Status; D006801:Humans; D020407:Internet; D008137:Longitudinal Studies; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D009426:Netherlands; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires