Editorial - Volume 15, Issue 1 - April 2013

As we approach the 1-year anniversary of the inauguration of the IJMSC's new website (http://ijmsc.org), which has allowed for improved searchability of our content as well as increasing the publication's general visibility, we also celebrate our entrance into social media with the recent launch of a Twitter feed (http://twitter.com/IJMSCtweets) as well as continued discussions on our LinkedIn group. We plan to continue to grow the electronic presence of the journal, thus making it more accessible and more immediate to our diverse group of current readers and potential new readers. In keeping with the theme of making use of new technologies, of the seven articles in this Spring issue of the IJMSC, approximately half promote the use of methods other than the traditional, office-based visit to enhance the care of MS patients.

In the most ambitious use of alternative methods of care, Dr. Turner and colleagues at the VA MS Centers of Excellence in both Seattle and Washington, DC, explore the clinical management of MS through home telehealth. In this pilot project, 41 veterans with MS used home telehealth monitors, and their rate of satisfaction with this form of care was high. The authors concluded that telehealth monitoring is a promising mechanism for the management of chronic disease, although substantial practical barriers to its implementation remain. In another article, Dr. Tompkins of Madipen Consulting in Fort Collins, Colorado, and colleagues describe their use of a combination of workshops and teleconferences to promote enhanced relationships among couples living with MS. Their results indicated that the program “Relationship Matters,” developed and sponsored by the National Multiple Sclerosis Society, led to significantly increased relationship satisfaction. The authors also found that alternative modes of program delivery, such as teleconferencing, warrant further exploration. Dr. Finlayson and colleagues at the University of Illinois at Chicago (Dr. Finlayson has since moved to Queen's University in Kingston, Ontario, Canada) also utilized teleconferences to deliver a fatigue self-management education program. Their article in this issue examines whether the presence of one or more of six chronic health conditions moderated the effectiveness of the program.

Switching from clinician-provided electronic content to patient-provided data, Dr. Janzen and colleagues at the Canadian Universities of Alberta and Manitoba in Edmonton and Winnipeg, respectively, used information from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry to assess the stability or lack thereof of MS patients' health-related quality of life (HRQOL) over 5 years. They found that 60% of patients were able to maintain a stable HRQOL over a 5-year period; patients who were most likely to experience deterioration in both physical and mental HRQOL were those with better HRQOL at the beginning of the study period.

The use of another type of patient-generated data is addressed by Dr. Larson of the University of Georgia in Athens (now with the University of Oklahoma in Norman) in her analysis of the psychometric properties of the Modified Fatigue Impact Scale. Given the huge impact that the symptom of fatigue has on MS patients, it is critical to understand the properties of this instrument. Also addressing the difficulties of measurement in MS patients are Ms. Toomey and Dr. Coote of the University of Limerick, Ireland. They assess the interrater reliability of two of the most frequently used scales in MS—the 6-Minute Walk test (6MW) and the Berg Balance Scale (BBS)—as well as handheld dynamometry in people with varying levels of disability. They found preliminary evidence that reliability decreases with increasing levels of disability for both the BBS and the 6MW.

Last but not least, Ms. Remington and colleagues of the University of Texas Southwestern MS Center in Dallas examine factors that can facilitate medication adherence in MS patients, finding that multiple factors must be considered in the choice of disease-modifying agent for an individual patient. They recommend addressing common reasons for nonadherence to increase patient self-efficacy and enhance communication between patients and health-care providers, and identify useful resources to help support patients.

In closing, I invite you to join our digital conversations on LinkedIn and Twitter, as well as those in person at the upcoming annual meeting of the Consortium of Multiple Sclerosis Centers (CMSC) in Orlando, Florida, from May 29 to June 1. This will be the fifth cooperative meeting of the CMSC with the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS). As always, we look forward to an exciting and productive interchange of clinically applicable research from all disciplines needed to provide comprehensive care for our MS patients.