Study findings indicate that people with multiple sclerosis (MS) often experience challenges accessing appropriate healthcare services to address their disease-related needs, including symptom management. One option for improving access to care for patients with MS is to use mobile health (mHealth) technology, defined as the use of mobile and wireless devices to improve health outcomes, healthcare services, and health research.

Over the last decade, mHealth use among patients with MS has grown considerably, with some technologies helping track and manage symptoms, communicating with healthcare professionals, and improving health-related quality of life. However, little is known about the frequency and types of mHealth being used and potential barriers to their use. “We need a better understanding of what has been seen in studies assessing mHealth in the MS population,” says Elizabeth S. Gromisch, PhD, MSCS. “If mHealth technology is not developed with patients in mind, it can reduce adoption of these services, which in turn, limit their utility.”

Seeking a Better Understanding of mHealth Use

Dr. Gromisch and colleagues had a literature review published in JAMIA Open that aimed to better understand mHealth use among patients with MS. “It was particularly important for us to examine the barriers that people with MS face when using mHealth,” says Dr. Gromisch. “We also wanted to identify important technological considerations when developing mHealth for this patient population.”

The study reviewed the frequency for which patients with MS used mHealth, how the MS population used it, and potential barriers and technological considerations that may affect mHealth use. The authors identified 59 peer-reviewed studies conducted in patients with MS that were published druing 2010-2019. All studies in the analysis assessed the use of mHealth, as well as barriers to using it and technological considerations.

Patients Often Express Interest in Using mHealth

According to the results, most patients with MS used smartphones on a regular basis, with many using these devices for mHealth, but rates of utilization varied widely. Several types of mHealth tools were identified, including those that measure symptoms, help with managing symptoms, and assist with treatment adherence.

“With increasing attention being given to mHealth over the last few years, more people with MS may come into the office and report using some type of tool to help manage their symptoms,” Dr. Gromisch says. “Some might be using an app for tracking symptoms or a wearable device. Others may be participating in an intervention using their tablet or smartphone. Clinicians should recognize that their patients may be interested in incorporating mHealth as part of their MS treatment plan. As such, it’s important to be aware of what’s out there so clinicians can talk to patients about resources that may be beneficial to them.”

Beware of Barriers to mHealth Use

Several barriers to adopting and using mHealth were identified in the study, some of which were specifically related to MS symptoms, like difficulties with vision, fine motor control, and memory. Other barriers identified in the study—such as digital literacy, costs, and interface design—also apply to mHealth in general.

Clinicians who manage older patients with MS are recommended to train them on using mHealth devices or apps to promote greater uptake of these tools. “If clinicians are interested in incorporating more technology into their practice, it’s important to be aware of the barriers their patients may face and how to help them overcome these barriers,” says Dr. Gromisch (Table). “For example, clinicians who manage patients with visual impairments and struggle to read small text can recommend using bigger devices, like tablets, or assistive technologies, like text-to-speech.”

Involve Patients to Better Meet Their Needs

Including patients and healthcare professionals in the design process for mHealth tools may provide clarity on potential MS-related limitations and solutions before products are tested commercially. “Including patients as stakeholders in the design process is crucial to ensuring that the end product meets the needs of its users and will be implemented in everyday life,” Dr. Gromisch says.

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