The applicability of mobile digital technology to promote clinical care of people with multiple sclerosis (MS) is gaining traction as part of the implementation of patient-centered approaches. As such, a study published in PLoS One aimed to assess adherence to a smartphone-based e-diary, which was designed to collect patient-reported outcomes (PROs).

In this observational cohort study, researchers assessed 97 patients with MS who downloaded an MS tailored e-diary into their personal smartphones. PROs were enquired once monthly over the duration of one year through a smartphone-based application. An e-diary derived bodily function summary score (eBF) was defined in this analysis as the sum of scores depicting vision, limb function, pain, bowl/ bladder dysfunction, pseudobulbar affect, and spasticity. Multiple linear regression and analysis of covariance were used to determine the association between PROs, clinician-reported outcomes (ClinROs) of disease activity, and quality of life (QoL). Regression coefficient analysis was used to compare the slope of change in eBF before and after a relapse.

Overall, 78% of people completed the 12-month study period, and 55% of patients submitted ≥75% of requested surveys. The study found that anxiety was negatively associated with adherence to periodic PROs assessments by the e-diary. E-diary derived PROs were significantly correlated with corresponding functional system scores (P<0.001).

Adherence of pwMS to recording in an e-diary collecting PROs was high. Changes in e-diary derived PROs over time predict clinical MS relapses on the group level and thus carry the potential of usage in clinical research as well as for improved MS care in real world setting,” the researchers concluded.


Keywords: pseudobulbar affect, stroke, hypomania, mania, depression, antipsychotics, antidepressants