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. 2021 Feb 2;7(1):2055217321988937.
doi: 10.1177/2055217321988937. eCollection 2021 Jan-Mar.

CoachMS, an innovative closed-loop, interdisciplinary platform to monitor and proactively treat MS symptoms: A pilot study

Valerie J Block  1 , Arpita Gopal  2 , William Rowles  1 , Chu -Yueh  1 , Jeffrey M Gelfand  1 , Riley Bove  1
Affiliations

CoachMS, an innovative closed-loop, interdisciplinary platform to monitor and proactively treat MS symptoms: A pilot study

Valerie J Block et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: There are numerous challenges to treating co-occurring symptoms in multiple sclerosis (MS).

Objective: To pilot the feasibility of a novel symptom management platform, CoachMS, to monitor MS symptoms (bladder function, ambulation, and mood: BAM) and respond to changes in real-time.

Methods: In this 12-week randomized controlled pilot trial, participants' symptoms were monitored using weekly questionnaires and remote ambulatory monitoring (Fitbit Flex2®). Behavioral change principles used included shared goal setting at 2 weeks. Between weeks 2-12, the CoachMS group received targeted contact and interventions if symptoms worsened; the control group were treated through usual clinic practice. Our outcomes were feasibility (retention, adherence and acceptability; primary) and proportion of recommended treatments pursued (secondary); efficacy was explored.

Results: Of 21 participants enrolled, 13 (62%) completed the study; protocol adherence was excellent. CoachMS participants demonstrated greater follow-through with clinical recommendations than controls (OR 9.3, 95% CI (0.9, 97.6)). As a cohort, each BAM symptom tended to improve. Suicidality was detected in one control participant, resulting in urgent evaluation and hospitalization.

Conclusions: The innovative CoachMS platform was feasible and acceptable in this cohort with baseline BAM symptoms. It could represent an accessible, cost-effective tool to monitor MS symptoms in real-time; a larger trial is planned.

Keywords: Multiple sclerosis; clinical trial; digital health; quality of life; rehabilitation; symptomatic treatment.

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Figures

Figure 1.
Figure 1.
Study design.
Figure 2.
Figure 2.
CONSORT flow diagram.
See this image and copyright information in PMC

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