A First-in-Kind Randomized, Controlled Pilot Clinical Trial Testing Proactive vs Reactive Management of a Symptom Triad in Multiple Sclerosis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Multiple Sclerosis
- Sponsor
- University of California, San Francisco
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Feasibility of an active symptom monitoring and intervention protocol
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
The purpose of this 12-week, exploratory pilot clinical trial is to continuously and remotely assess a triad of bothersome multiple sclerosis (MS) symptoms (BAM: bladder, ambulation, mood) and test the benefit of proactively treating these symptoms according to an evidence-based, multi-disciplinary, personalized protocol.
Detailed Description
MS is a chronic, debilitating disease of the central nervous system affecting approximately 2 million people worldwide and more than 400,000 individuals in the US. MS is the most common cause of non-traumatic neurological disability in young adults. Symptoms typically first afflict individuals during the prime of their professional and reproductive lives, between the ages of 20 and 40. Many affected individuals are unemployed, physically disabled, and at high risk for social isolation. While disease-modifying therapies (DMTs) can significantly reduce accumulation of disability in MS, patients still experience symptoms across a range of functional domains. Symptoms can include problems with bladder, walking, and mood (depression and anxiety). Often, these symptoms are only partially evaluated during routine MS clinic visits, and the long interval between clinic visits can result in them not being optimally managed. The goal of the current study is to pilot a system of proactively monitoring a combination of symptoms (bladder, ambulation and mood) using an activity monitor and a smartphone. Adult patients with MS who are experiencing symptoms in at least 2 of the 3 domains (bladder, ambulation, mood) will be enrolled. Visits will be at baseline (can be same day as routine visit to the MS clinic), and 3 months. Short surveys (\<3 minutes to complete) will occur weekly, and longer surveys will occur at baseline, 6 weeks and 3 months. FitBit activity monitors will be worn for the entire 3 months.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Any individual above the age of 18 with a confirmed diagnosis of MS
- •Access to a smartphone
- •Access to Wi-Fi at home
- •Able to walk (including with a cane or walker)
- •Willing to fill out surveys at multiple time points
Exclusion Criteria
- •Clinician's assessment of cognitive, dexterity, or visual impairment limiting ability to use a smartphone and subsequent technologies required by the study
- •Inability to walk
Outcomes
Primary Outcomes
Feasibility of an active symptom monitoring and intervention protocol
Time Frame: 12 weeks
To evaluate feasibility of the intervention, we will calculate how many patients remain in the study, levels of patient satisfaction with the monitoring and intervention, and we will analyze patient and provider feedback.
Secondary Outcomes
- Improvement in bladder symptoms in MS participants.(12 weeks)
- Improvement in mood symptoms in MS participants.(12 weeks)
- Improvement in ambulation symptoms in MS participants(12 weeks)