Digital Tool Aimed at Detecting MS Progression May Help Providers Facilitate Discussion With Patients

A digital tool aimed at facilitating discussions on disease progression between health care professionals (HCPs) and patients with multiple sclerosis (MS) was found to be a useful and usable tool in daily clinical practice, investigators concluded from survey results.

The cross-sectional, web-based survey analysis, published in the Journal of Medical Internet Research, highlighted the overall willingness of HCPs to implement and use the Multiple Sclerosis Progression Discussion Tool (MSProDiscuss).

“The tool was used by physicians, MS nurses and nurse practitioners, and pharmacists from very different practice settings and was found to be of value; MSProDiscuss is a tool that is acceptable to all the users involved in the care and management of patients with MS,” said the investigators.

One of the challenges of caring for patients with MS is being able to differentiate between relapsing-remitting MS and secondary progressive MS because there is no clear consensus on the diagnostic criteria for progression and reliable biomarkers of disease progression have not been established. The delay in detecting MS progression may affect long-term prognosis and treatment decision-making. A tool to facilitate systematic assessment of early signs of MS progression in routine clinical practice may help providers overcome this challenge.

The MSProDiscuss tool aims to connect physicians with patients and help to assess early, subtle signs suggestive of MS progression. The tool relies on a set of weighted questions that collect information on disease activity, symptoms, and impact of symptoms on daily living from the past 6 months. The tool generates a traffic light approach to predict progression:

• Green indicates that the patient is unlikely to be showing signs of progression
• Yellow indicates that some signs may be present
• Red indicates that the patient is very likely showing signs of progression

HCPs were invited by representatives of the study sponsor, Novartis, to participate, and the survey was conducted between July 2019 and December 2019 in 34 countries. The participants were asked to fill out an initial questionnaire and a final questionnaire. The initial questionnaire was conducted for every patient for whom the MSProDiscuss tool was used and the final questionnaire was conducted at the end to assess the integration of the tool into clinical practice.

Of the 390 HCPs who were invited, 301 tested the tool in 6974 patients with MS. The majority (81.7%) of the HCPs were MS specialists; however, MS nurses, neurologists, nurse practitioners, and physician assistants also participated. The participants were expected to conduct between 10 and 40 initial questionnaires, of whom 232 did so. The final questionnaire was completed by 274 HCPs.

In 93.5% of the initial questionnaires and 97.1% of the final questionnaires, the HCPs agreed that patients were able to comprehend the questions within the tool. Additionally, in 90.5% of the initial questionnaires, the HCPs expressed a willingness to use the tool again in the same patient.

The participants reported that the tool was useful in discussing patient symptoms and the impact on daily activities in 87.8% of the initial questionnaires and in 92.0% of the final questionnaires. The tool was also reported to be useful in discussing cognitive function (78.6% of initial; 79.2% of final) and progression in general (87.5% of initial; 89.8% of final).

Overall, 92% of the HCPs said that they would recommend MSProDiscuss to a colleague and 85.8% said that they were willing to integrate the tool into their clinical practice.

Collecting feedback on the tool while simultaneously using it was listed as a study limitation because it may have created a potential bias in the HCPs’ responses to some components of the survey. Additionally, the investigators said that the questionnaire methodology could only shed light on trends or attitudes but could not explain the underlying reasons for the responses.

“Although centers with a heavy patient inflow might find it difficult to implement a new tool in their workflow, our results show that HCPs across different practice settings can easily integrate MSProDiscuss into their routine practice,” the investigators noted.

Reference

Ziemssen T, Giovannoni G, Alvarez E, et al. Multiple sclerosis progression discussion tool usability and usefulness in clinical practice: cross-sectional, web-based survey. J Med Internet Res. 2021;23(10). doi:10.2196/29558