Impact of an electronic monitoring device and behavioral feedback on adherence to multiple sclerosis therapies in youth: results of a randomized trial.

Purpose: To report the results of a randomized controlled trial using an electronic monitoring device (EM) plus a motivational interviewing (MI) intervention to enhance adherence to disease-modifying therapies (DMT) in pediatric MS.Methods: Fifty-two youth with MS (16.03 ± 2.2 years) were randomized...

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Published in:Quality of Life Research Vol. 26; no. 9; pp. 2333 - 2350
Main Authors: Yeh, E. Ann, Grover, Stephanie, Powell, Victoria, Alper, Gulay, Banwell, Brenda, Edwards, Kim, Gorman, Mark, Graves, Jennifer, Lotze, Timothy, Mah, Jean, Mednick, Lauren, Ness, Jayne, Obadia, Maya, Slater, Ruth, Waldman, Amy, Waubant, Emmanuelle, Schwartz, Carolyn, Grover, Stephanie A, Powell, Victoria E, Banwell, Brenda L
Format: research randomized controlled trial Journal Article
Published: Springer Nature Sep2017
Online Access:View this record in EBSCOhost
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      dt: Sep2017
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s11136-017-1571-z
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        atl: Impact of an electronic monitoring device and behavioral feedback on adherence to multiple sclerosis therapies in youth: results of a randomized trial.
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        au:
          Yeh, E. Ann
          Grover, Stephanie
          Powell, Victoria
          Alper, Gulay
          Banwell, Brenda
          Edwards, Kim
          Gorman, Mark
          Graves, Jennifer
          Lotze, Timothy
          Mah, Jean
          Mednick, Lauren
          Ness, Jayne
          Obadia, Maya
          Slater, Ruth
          Waldman, Amy
          Waubant, Emmanuelle
          Schwartz, Carolyn
          Grover, Stephanie A
          Powell, Victoria E
          Banwell, Brenda L
        affil: Pediatric MS and Neuroinflammatory Disorders Program, Division of Neurology, Department of Pediatrics, Neuroscience and Mental Health, Hospital for Sick Children Research Institute , Hospital for Sick Children , 555 University Avenue, Rm 6D33 Toronto M5G1X8 Canada
      sug:
        subj:
          Quality of Life Psychosocial Factors
          Medication Compliance
          Health Behavior
          Male
          Human
          Multiple Sclerosis Pathology
          Adolescence
          Female
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Randomized Controlled Trials
          Funding Source
          Adolescent: 13-18 years
          Male
          Female
      ab: Purpose: To report the results of a randomized controlled trial using an electronic monitoring device (EM) plus a motivational interviewing (MI) intervention to enhance adherence to disease-modifying therapies (DMT) in pediatric MS.Methods: Fifty-two youth with MS (16.03 ± 2.2 years) were randomized to receive either MI (n = 25) (target intervention) or a MS medication video (n = 27) (attention control). Primary endpoint was change in adherence. Secondary outcomes included changes in quality of life, well-being and self-efficacy. Random effects modeling and Cohen's effect size computation evaluated intervention impact.Results: Longitudinal random effect models revealed that the MI group decreased their EM adherence (GroupxTime interaction = -0.19), while increasing frequency of parental DMT reminder (26.01)/administration (11.69). We found decreased EM use in the MI group at 6 months (Cohen's d = -0.61), but increased pharmacy refill adherence (d = 0.23). Parental reminders about medication increased in MI subjects vs controls (d = 0.59 at 3 months; d = 0.70 at 6 months). We found increases in self-reported adherence (d = 0.21) at 3 but not 6 months, fewer barriers to adherence at three (d = -0.58) and six months (d = -0.31), better physical (d = 0.23 at 3 months; d = 0.45 at 6 months), emotional (d = 0.25 at 3 months) and self-efficacy function (d = 0.55 at 3 months; 0.48 at 6 months), but worse well-being, including self-acceptance (d = -0.53 at 6 months) and environmental mastery (d = -0.42 at 3 and 6 months) in intervention as compared to control patients.Conclusions: Participants receiving MI + EM experienced worsening on objective measures of adherence and increased parental involvement, but improved on some self- and parent-reported measures. MI participants reported improvements in quality of life and self-efficacy, but worsened well-being.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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