Pilot Study May Lead to Telemedicine Benefiting People with Multiple Sclerosis

Telemedicine, which allows healthcare professionals to evaluate, diagnose and treat patients at a distance with telecommunications technology, may soon benefit people with multiple sclerosis (MS).

Elizabeth Morrison-Banks, MD, a health sciences clinical professor at the University of California at Riverside School of Medicine, is planning a pilot one-year study of a home-based telemedicine program for MS patients.

A $100,000 grant from Genentech is financing the project, which Morrison-Banks calls “Clinicians’ Online Neurology Network Empowering Communities through Telemedicine – Multiple Sclerosis (CONNECT-MS).”

“In 2015-2016, in collaboration with the Landon Pediatric Foundation, our research group developed a pilot telemedicine program for MS care funded by a Genentech research grant,” Morrison-Banks said in a news release. “While our preliminary data suggested that telemedicine is effective for and acceptable to patients with MS, outreach was limited by the complexity of scheduling visits to the general neurologists’ offices in coordination with simultaneous telemedicine consultations. We are therefore proposing a new home-based telemedicine program.”

As part of the project, Morrison-Banks and colleagues will randomize adults with MS to receive either telemedicine-based care or usual care.

A nurse practitioner will visit the telemedicine group’s homes, review their clinical history, and work with a neuro-immunologist who is on a telemedicine hook-up to perform a neurological analysis. The first stop at a patient’s home will be three to four weeks after the patient enrolls so the nurse can coordinate a telemedicine visit with Morrison-Banks. The privacy of such visits will be protected under the Health Insurance Portability and Accountability Act.

Researchers will compare the health of patients treated by telemedicine with those who received usual care. The variables they will examine include pain levels, fatigue, quality of life, visual impairment, sexual satisfaction, bowel control, bladder control, and mental health.

“The goal is to determine whether the home telemedicine approach works as well as usual care—that is, office visits with the neuro-immunologist,” Morrison-Banks said. “This is a pilot study and it may not be able to show whether MS telemedicine in patients’ homes is better than usual care, but if it appears to be equivalent – and if patients and families like it better because of its convenience and comfort – then the pilot study will provide useful preliminary data to guide larger research studies in the future.”

Many stroke patients have received teleneurology treatments. That branch of telemedicine allows those with neurological problems to use a telephone or the Internet to consult with a doctor. Teleneurology can make a huge difference for people in rural locations who have a major stroke. Quick access to a neurologist in the first minutes of a stroke can save a patient’s life.

Telemedicine is new to MS care, however, and its focus is different from acute stroke care. Many MS patients who live in rural communities want to access a specialist through telemedicine to avoid traveling a long distance to see a neuro-immunologist.

“People with advanced MS face additional barriers to traveling to an MS center, even if it is located nearby, because if they have a lot of disability, over time it tends to become increasingly difficult for them to leave their homes,” Morrison-Banks said. “So if we can bring the ‘medical home’ into people’s actual homes, we can meet multiple needs at the same time while allowing a safe and comfortable environment for the medical visit.”

Implementing any new technological solution is challenging, however, Morrison-Banks pointed out.

“Some people may miss the face-to-face experience with the MS specialist,” she said. “In our current telemedicine clinic for teens with MS, as one might expect, the teens adapt to the technology without missing a beat. I think these young people are going to lead the way for the rest of us in blending technological solutions into our everyday lives.”

Kristyn Pellecchia, a nurse practitioner who is a clinical assistant professor in the school of medicine, will join Morrison-Banks in the study. She visit patients’ homes to arrange the telemedicine visits, and gather patient data.