Connecting to the future – the promise of telecare

Porter, Bernadette; Thompson, Alan J.

doi:10.1177/1352458512441273

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…Telemedicine, described as the ''use of communication technologies to assist in the diagnosis and treatment of medical conditions through the transmission of data between two different physical places'', offers the potential of improving accessibility to health services [1] but reports on using this potentially promising technology with reliable markers of disability and walking activity are limited. Presently, the expanded disability status scale (EDSS) is the standard measurement of disability and disease progression in multiple sclerosis (MS), but it has several limitations.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, accelerometers have been introduced to measure continuous ambulation in real life conditions [7]. The aims of this longitudinal pilot study were: (1) to examine the feasibility of using a multimedia platform and determine the reliability of the obtained EDSS (multimedia EDSS) in comparison with the conventional EDSS (standard physical neurological examination), and (2) to explore the usefulness of monitoring continuous ambulation (daily walking activity measured by an accelerometer) to better characterize the patient's disability status and its potential use for detecting disease progression over time in a cohort of MS patients.…”

Section: Introductionmentioning

confidence: 99%

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Walking function in clinical monitoring of multiple sclerosis by telemedicine

et al. 2015

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Walking limitation is a key component of disability in patients with multiple sclerosis (MS), but the information on daily walking activity and disability over time is limited. To determine, (1) the agreement between the standard measurements of MS-related disability [expanded disability status scale (EDSS), functional systems (FS) and ambulation index (AI)] obtained by conventional and remote evaluation using a multimedia platform; (2) the usefulness of monitoring 6-min walk test (6MWT) and average daily walking activity (aDWA) to better characterize patients disability. Twenty-five patients (EDSS score 1.0-6.5) were evaluated every 3 months for the first year, and aDWA repeated at year 2. Remote visits included the recording of a video with self-performed neurological examination and specific multimedia questionnaires. aDWA was measured by a triaxial accelerometer. All but two patients completed the study. Modest agreement between conventional and multimedia EDSS was found for EDSS ≤ 4.0 (kappa = 0.2) and good for EDSS ≥ 4.5 (kappa = 0.6). For the overall sample, pyramidal, cerebellar and brainstem FS showed the greatest agreement (kappa = 0.7). SR-AI showed a modest agreement for EDSS ≤ 4.0 and good for EDSS ≥ 4.5 (kappa = 0.3 and 0.6, respectively). There was a strong correlation between conventional and 6MWT measured by accelerometer (r = 0.76). The aDWA correlated strongly with the EDSS (r = -0.86) and a cut-off point of 3279.3 steps/day discriminated patients with ambulatory impairment. There was a significant decline in aDWA over 2 years in patients with ambulatory impairment that were not observed by standard measurements of disability. MS clinical monitoring by telemedicine is feasible, but the observed lower agreement in less disabled patients emphasizes the need to optimize the assessment methodology. Accelerometers capture changes that may indicate deterioration over time.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Walking function in clinical monitoring of multiple sclerosis by telemedicine

et al. 2015

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“…A pilot study by Zissman et al [8] found that people who were supported by a home telecare model showed improvement in their disease severity and had an increased level of satisfaction with provided care, compared to the group of MS patients receiving standard care [9].…”

Section: Introductionmentioning

confidence: 99%

“…In the MS arena, it has been claimed that the Department of Veterans’ Affairs leads the development of telesupport for MS. Studies from the US have shown that American MS patients spend much more time on the internet than the average person, giving web-based interventions a potential weight [9].…”

Section: Introductionmentioning

confidence: 99%

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RebiQoL: A randomized trial of telemedicine patient support program for health-related quality of life and adherence in people with MS treated with Rebif

et al. 2019

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RebiQoL was a phase IV multicenter randomized study to assess the impact of a telemedicine patient support program (MSP) on health-related quality of life (HRQoL) in patients with relapsing-remitting MS (RRMS) being administered with Rebif with the RebiSmart device. The primary endpoint was to assess the impact of MSP compared to patients only receiving technical support for RebiSmart on HRQoL at 12 months, using the psychological part of Multiple Sclerosis Impact Scale (MSIS-29), in patients administered with Rebif. A total of 97 patients diagnosed with RRMS were screened for participation in the study of which 3 patients did not fulfill the eligibility criteria and 1 patient withdrew consent. Of the 93 randomized patients, 46 were randomized to MSP and 47 to Technical support only. The demographic characteristics of the patients were well-balanced in the two arms. There were no statistical differences (linear mixed model) in any of the primary (difference of 0.48, 95% CI: -8.30–9.25, p = 0.91) or secondary outcomes (p>0.05). Although the study was slightly underpowered, there was a trend towards better adherence in the MSP group (OR 3.5, 95% CI 0.85–14.40, p = 0.08) although not statistically significant. No unexpected adverse events occurred. This study did not show a statistically significant effect of the particular form of teleintervention used in this study on HRQoL as compared to pure technical support, for MS patients already receiving Rebif with the RebiSmart device. Trial Registration : ClinicalTrials.gov: NCT01791244 .

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Rehabilitation in People with Progressive MS

Freeman¹

2017

Progressive Multiple Sclerosis

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Connecting to the future – the promise of telecare

Cited by 4 publications

References 18 publications

Walking function in clinical monitoring of multiple sclerosis by telemedicine

Walking function in clinical monitoring of multiple sclerosis by telemedicine

RebiQoL: A randomized trial of telemedicine patient support program for health-related quality of life and adherence in people with MS treated with Rebif

Rehabilitation in People with Progressive MS

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