The Use of Digital and Remote Communication Technologies as a Tool for Multiple Sclerosis Management: Narrative Review.
Martin Marziniak, Giampaolo Brichetto, Peter Feys and 3 others
PMID 29691208WHAT IT FOUND
Evidence for MS digital tools is mostly small studies; large trials are lacking, so do not assume they improve outcomes.
Many are usable and accepted.
Key findings
01The review describes 28 eHealth solutions for MS, including 14 web-based tools, 11 apps, and 3 home-based technology solutions.
02Large controlled multicenter trials are lacking, so objective conclusions about clinical benefits are difficult.
03A 9-week randomized trial of Deprexis in 90 patients with MS showed lower depression scores than waiting list.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review based on a targeted search and authors' experience, not a systematic review, so it may not capture all relevant evidence. Many solutions are early-stage or small studies, including pilots with 12 patients for HAT and 11 patients for move II. Large controlled multicenter trials are lacking; only MSInvigor8 and Deprexis were phase 2 trials. Some positive findings are not from primary outcomes; for example, Web Based Physio did not show a significant difference in its primary walking outcome. Authors have financial relationships with companies whose products are discussed, and some programs are industry-sponsored. Patients may face barriers such as limited Internet access, cost, dexterity problems, visual or cognitive website issues, and concerns about data security.
Declared interests
Several authors reported lecture fees, travel grants, consulting fees, or research support from companies including Bayer HealthCare, Beiersdorf, Biogen Idec, Merck, Novartis, Pfizer, Sanofi-Aventis, Teva, Almirall, Boehringer Ingelheim, and UCB. One author had nothing to disclose. The conflicts section lists author disclosures but does not name a funder for the review.
The easy way to misread this
Do not read this review as proof that digital or remote tools improve MS outcomes. The paper says large controlled multicenter trials are lacking, and some included studies were pilots or had null primary walking outcomes.