Nav: Home

Using telemedicine to treat multiple sclerosis

March 10, 2017

RIVERSIDE, Calif. - Multiple sclerosis (MS) clinicians face continued challenges in optimizing neurological care, especially for people with advanced MS living in medically underserved communities. Because of insurmountable geographical and physical challenges, patients cannot always travel to neurology office appointments.

Could telemedicine -- the use of telecommunication and information technology to provide clinical health care from a distance -- be effectively used to address this problem? A researcher in the School of Medicine at the University of California, Riverside is set to find out.

Elizabeth Morrison-Banks, M.D., a health sciences clinical professor who studies MS, including the mistreatment of people with advanced MS, has received a $100,000 grant from Genentech, a biotechnology company, to develop and pilot-test a new home-based telemedicine program geared toward treating MS patients.

The one-year project is titled "Clinicians' Online Neurology Network Empowering Communities through Telemedicine - Multiple Sclerosis (CONNECT-MS)."

MS is an autoimmune disease of the brain and spinal cord, impacting about 2.3 million people worldwide (400,000 in the United States). Affecting more women than men, it can be seen at any age, although it is most commonly diagnosed between the ages of 15 and 50. Early disease-modifying therapy has been found to slow the progression of this unpredictable disease and lessen long-term disability.

"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. "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."

Morrison-Banks said her research group will randomly assign participating adults with MS to an intervention group that will receive telemedicine intervention versus a control group that will be offered the usual care. For the intervention group, a nurse practitioner will visit patients in their homes, review the history and perform a neurological examination in collaboration with a neuro-immunologist at UC Riverside who will participate through a telemedicine connection.

The CONNECT-MS project's nurse practitioner will visit each patient at home within three to four weeks after study enrollment to coordinate a HIPAA-protected telemedicine visit with Morrison-Banks. Together, the nurse practitioner and neuro-immunologist will conduct an intake visit, reviewing the patient's history, performing a neurological examination and going over laboratory results and neuro-imaging before discussing decisions about work-up and management with the patient and family.

The research group will compare the intervention versus control groups for a number of variables, including quality of life, pain levels, fatigue, sexual satisfaction, bladder control, bowel control, visual impairment, 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."

"Tele-neurology" is now a popular approach for stroke care because it allows rural communities rapid access to a qualified neurologist in those crucial first minutes of an acute stroke, when decisions need to be made about whether to initiate interventions that can sometimes be lifesaving.

Morrison-Banks said that telemedicine is newer in MS care and the focus is different from acute stroke care. People living with MS in rural areas can access a fellowship-trained MS specialist through telemedicine in a way that may never be possible for them if they had to travel long distances to get to the neuro-immunologist's office.

"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," she 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."

She noted that caveats include the challenges of implementing any new technological solution.

"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."

Morrison-Banks will be joined in the research by Kristyn Pellecchia, a clinical assistant professor in the School of Medicine and a nurse practitioner who will visit patients' homes to conduct the telemedicine visits and collect clinical research data. She will also participate as a co-investigator in the research study.

MS is the leading cause of non-traumatic disability among young adults in the United States. A disease that disrupts the flow of information within the brain and between the brain and the body, MS is triggered when the immune system attacks the myelin sheath, the protective covering around the axons of nerve fibers. The "demyelination" that follows causes a disruption of nerve impulses. As the protective sheath - best imagined as the insulating material around an electrical wire -- wears off, the nerve signals slow down or stop, and the patient's vision, sensation and use of limbs get impaired. Permanent paralysis can result when the nerve fibers are completely damaged by the disease.
-end-
About the UCR School of Medicine

The first public medical school created in California in more than 40 years, the UCR School of Medicine will graduate its first class of students in 2017. Its mission is to improve the health of the people of California and, especially, to serve inland Southern California by training a diverse workforce of physicians and by developing innovative research and health care delivery programs that will improve the health of the medically underserved in the region and become models to be emulated throughout the state and nation.

About Genentech

Founded 40 years ago, Genentech is a leading biotechnology company that discovers, develops, manufactures and commercializes medicines to treat patients with serious or life-threatening medical conditions. A member of the Roche Group, the company has headquarters in South San Francisco, Calif.

The University of California, Riverside is a doctoral research university, a living laboratory for groundbreaking exploration of issues critical to Inland Southern California, the state and communities around the world. Reflecting California's diverse culture, UCR's enrollment is now nearly 23,000 students. The campus opened a medical school in 2013 and has reached the heart of the Coachella Valley by way of the UCR Palm Desert Center. The campus has an annual statewide economic impact of more than $1 billion. A broadcast studio with fiber cable to the AT&T Hollywood hub is available for live or taped interviews. UCR also has ISDN for radio interviews. To learn more, call (951) UCR-NEWS.

University of California - Riverside

Related Multiple Sclerosis Articles:

The gut may be involved in the development of multiple sclerosis
It is incompletely understood which factors in patients with multiple sclerosis act as a trigger for the immune system to attack the brain and spinal cord.
Slowing the progression of multiple sclerosis
Over 77,000 Canadians are living with multiple sclerosis, a disease whose causes still remain unknown.
7T MRI offers new insights into multiple sclerosis
Investigators from Brigham and Women's Hospital have completed a new study using 7 Tesla (7T) MRI -- a far more powerful imaging technology -- to further examine LME in MS patients
AAN issues guideline on vaccines and multiple sclerosis
Can a person with multiple sclerosis (MS) get regular vaccines?
How to improve multiple sclerosis therapy
Medications currently used to treat multiple sclerosis (MS) can merely reduce relapses during the initial relapsing-remitting phase.
Vaccinations not a risk factor for multiple sclerosis
Data from over 12,000 multiple sclerosis (MS) patients formed the basis of a study by the Technical University of Munich (TUM) which investigated the population's vaccination behavior in relation to MS.
Obesity worsens disability in multiple sclerosis
Obesity is an aggravating factor in relapsing-remitting multiple sclerosis, the most common form of the disease.
A new culprit for multiple sclerosis relapses
A molecule that helps blood clot may also play a role in multiple sclerosis relapses, researchers report in the May 6, 2019 issue of PNAS.
Multiple sclerosis: Perilous ruptures
The permanent neurological deficits of multiple sclerosis patients largely depend on the extent of degeneration of long nerve fibers.
Multiple sclerosis -- Helping cells to help themselves
Diseases such as multiple sclerosis are characterized by damage to the 'myelin sheath', a protective covering wrapped around nerve cells akin to insulation around an electrical wire.
More Multiple Sclerosis News and Multiple Sclerosis Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Accessing Better Health
Essential health care is a right, not a privilege ... or is it? This hour, TED speakers explore how we can give everyone access to a healthier way of life, despite who you are or where you live. Guests include physician Raj Panjabi, former NYC health commissioner Mary Bassett, researcher Michael Hendryx, and neuroscientist Rachel Wurzman.
Now Playing: Science for the People

#544 Prosperity Without Growth
The societies we live in are organised around growth, objects, and driving forward a constantly expanding economy as benchmarks of success and prosperity. But this growing consumption at all costs is at odds with our understanding of what our planet can support. How do we lower the environmental impact of economic activity? How do we redefine success and prosperity separate from GDP, which politicians and governments have focused on for decades? We speak with ecological economist Tim Jackson, Professor of Sustainable Development at the University of Surrey, Director of the Centre for the Understanding of Sustainable Propserity, and author of...
Now Playing: Radiolab

An Announcement from Radiolab