TY - JOUR
T1 - Impact of an electronic monitoring device and behavioral feedback on adherence to multiple sclerosis therapies in youth
T2 - results of a randomized trial
AU - On Behalf Of The Pediatric Ms Adherence Study Group
AU - Yeh, E. Ann
AU - Grover, Stephanie A.
AU - Powell, Victoria E.
AU - Alper, Gulay
AU - Banwell, Brenda L.
AU - Edwards, Kim
AU - Gorman, Mark
AU - Graves, Jennifer
AU - Lotze, Timothy E.
AU - Mah, Jean K.
AU - Mednick, Lauren
AU - Ness, Jayne
AU - Obadia, Maya
AU - Slater, Ruth
AU - Waldman, Amy
AU - Waubant, Emmanuelle
AU - Schwartz, Carolyn E.
AU - Aaen, Gregory
AU - Alper, Gulay
AU - Banwell, Brenda L.
AU - Belsole, Charlene
AU - Berenbaum, Tara
AU - Breiner, Petra
AU - Camposano, Susana
AU - Chohan, Hardeep
AU - Darrell, Carolynn
AU - Dowdy, Sarah
AU - Edwards, Kim
AU - Gorman, Mark
AU - Graves, Jennifer
AU - Grayson, La June
AU - Grover, Stephanie A.
AU - Haig, Tiffany
AU - Hamer, Sabrina
AU - Hart, Janace
AU - Jenkins, Kawonas
AU - Lavery, Amy
AU - Liu, Geraldine
AU - Lotze, Timothy
AU - Mahabir, Rory
AU - Mar, Soe
AU - Mednick, Lauren
AU - Mendoza, Elva R.
AU - Moodley, Manikum
AU - Ness, Jayne
AU - Noguera, Austin
AU - Obadia, Maya
AU - Petty, Marvin
AU - Pope, Sarah Planchon
AU - Tillema, Jan Mendelt
N1 - Publisher Copyright:
© 2017, Springer International Publishing Switzerland.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Purpose: To report the results of a randomized controlled trial using an electronic monitoring device (EM) plus a motivational interviewing (MI) intervention to enhance adherence to disease-modifying therapies (DMT) in pediatric MS. Methods: Fifty-two youth with MS (16.03 ± 2.2 years) were randomized to receive either MI (n = 25) (target intervention) or a MS medication video (n = 27) (attention control). Primary endpoint was change in adherence. Secondary outcomes included changes in quality of life, well-being and self-efficacy. Random effects modeling and Cohen’s effect size computation evaluated intervention impact. Results: Longitudinal random effect models revealed that the MI group decreased their EM adherence (GroupxTime interaction = −0.19), while increasing frequency of parental DMT reminder (26.01)/administration (11.69). We found decreased EM use in the MI group at 6 months (Cohen’s d = −0.61), but increased pharmacy refill adherence (d = 0.23). Parental reminders about medication increased in MI subjects vs controls (d = 0.59 at 3 months; d = 0.70 at 6 months). We found increases in self-reported adherence (d = 0.21) at 3 but not 6 months, fewer barriers to adherence at three (d = −0.58) and six months (d = −0.31), better physical (d = 0.23 at 3 months; d = 0.45 at 6 months), emotional (d = 0.25 at 3 months) and self-efficacy function (d = 0.55 at 3 months; 0.48 at 6 months), but worse well-being, including self-acceptance (d = −0.53 at 6 months) and environmental mastery (d = −0.42 at 3 and 6 months) in intervention as compared to control patients. Conclusions: Participants receiving MI + EM experienced worsening on objective measures of adherence and increased parental involvement, but improved on some self- and parent-reported measures. MI participants reported improvements in quality of life and self-efficacy, but worsened well-being.
AB - Purpose: To report the results of a randomized controlled trial using an electronic monitoring device (EM) plus a motivational interviewing (MI) intervention to enhance adherence to disease-modifying therapies (DMT) in pediatric MS. Methods: Fifty-two youth with MS (16.03 ± 2.2 years) were randomized to receive either MI (n = 25) (target intervention) or a MS medication video (n = 27) (attention control). Primary endpoint was change in adherence. Secondary outcomes included changes in quality of life, well-being and self-efficacy. Random effects modeling and Cohen’s effect size computation evaluated intervention impact. Results: Longitudinal random effect models revealed that the MI group decreased their EM adherence (GroupxTime interaction = −0.19), while increasing frequency of parental DMT reminder (26.01)/administration (11.69). We found decreased EM use in the MI group at 6 months (Cohen’s d = −0.61), but increased pharmacy refill adherence (d = 0.23). Parental reminders about medication increased in MI subjects vs controls (d = 0.59 at 3 months; d = 0.70 at 6 months). We found increases in self-reported adherence (d = 0.21) at 3 but not 6 months, fewer barriers to adherence at three (d = −0.58) and six months (d = −0.31), better physical (d = 0.23 at 3 months; d = 0.45 at 6 months), emotional (d = 0.25 at 3 months) and self-efficacy function (d = 0.55 at 3 months; 0.48 at 6 months), but worse well-being, including self-acceptance (d = −0.53 at 6 months) and environmental mastery (d = −0.42 at 3 and 6 months) in intervention as compared to control patients. Conclusions: Participants receiving MI + EM experienced worsening on objective measures of adherence and increased parental involvement, but improved on some self- and parent-reported measures. MI participants reported improvements in quality of life and self-efficacy, but worsened well-being.
KW - Behavioral intervention
KW - Multiple sclerosis
KW - Pediatric
KW - Quality of life
KW - Well-being
UR - http://www.scopus.com/inward/record.url?scp=85017180430&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85017180430&partnerID=8YFLogxK
U2 - 10.1007/s11136-017-1571-z
DO - 10.1007/s11136-017-1571-z
M3 - Article
C2 - 28393317
AN - SCOPUS:85017180430
SN - 0962-9343
VL - 26
SP - 2333
EP - 2349
JO - Quality of Life Research
JF - Quality of Life Research
IS - 9
ER -