An evaluation of remote monitoring in people with MS during the COVID-19 pandemic

ABSTRACT

Introduction: The COVID-19 pandemic caused major disruption to health services across the Globe, including the UK. Quick adaptations were required to switch from face-to-face to remote consultations and to further develop remote monitoring (RM) of people with multiple sclerosis (pwMS) in the community. Objective: To evaluate the views of pwMS under the care of our team who participated in RM. Methods: RM included completion of the nine-hole peg test, Timed 25-foot walk, ABILHAND questionnaire and WebEDSS at home. Electronic health records were queried for pwMS who participated in RM from May 2020-July 2020. Questionnaires (N=72) were sent via post or email asking about their experience of RM. Data were analysed using descriptive statistics. This service evaluation project was registered with the clinical effectiveness unit at Barts Health NHS Trust (Registration11945). Results: 23 pwMS (mean age 49 years (SD11.7);18 women, 5 men;relapsing MS 17;progressive MS 6;EDSS 0-8) responded to the survey. The majority viewed RM as a way for healthcare professionals to provide pwMS with the necessary support (83%) and to manage MS symptoms (70%);65% were keen to know more about how RM scores can be used to help them manage their MS symptoms. Overall, 60% of respondents felt confident completing assessments at home;52% said they will continue with RM after the pandemic. Conclusions: RM enabled monitoring of pwMS during the pandemic. Results suggest pwMS understood and generally agreed with the intentions of RM. There is also evident potential to facilitate patient activation and self-management. The apparent reluctance to continue RM in half of our sample after the pandemic warrants further exploration. Whilst bias may play a role due to limited returns, further reasons may include lack of digital confidence and associated risk of health inequalities.