Pharmacotherapy plays a key role in the management of chronic ^diseases1. However, its effectiveness is closely linked to the patient's adherence to medical ^{recommendations2}, which in turn depends on a number of factors, including the patient's support for treatment and a trusted relationship with the ^doctor3. 

In this article, you will learn how neurology specialists have used the Doctor.One platform for the ongoing medical care of patients with multiple sclerosis (MS) to increase the effectiveness of therapy and improve the quality of care. 

‍Pharmacotherapyin MS and its limitations

The cornerstone of the MS treatment process is long-term pharmacotherapy. Regular medication is essential to control symptoms and delay the progression of the ^disease4. However, the effectiveness of therapy drops significantly when ^patient adherence is low4. According to research, one of the key factors negatively affecting adherence in MS therapy is the patient's lack of knowledge about the disease and the treatment ^process5. This is caused by insufficient support from the treating physician (or nurse/rza or care coordinator⁾⁶ and insufficient ^education7. Therefore, patient support ^programs7, educational programs, trusted and ongoing physician (or care coordinator)-patient communication are proving to be most effective in maintaining patient adherence and effectiveness of MS ^treatment4. 

‍Mainchallenges of MS patients and attending physicians* .

On average, a patient with MS is in contact with his or her treating physician once every three months. This traditional model of care, which relies solely on inpatient visits that are far apart in time, is not conducive to maintaining high adherence. In practice, this means that patients are left unsupported between visits, with numerous questions or complaints for which they seek answers on their own, often using unreliable sources of information. Attending physicians, on the other hand, lack safe and effective tools to remotely monitor patients' therapy, receive feedback on their condition, and a channel to communicate and modify the treatment process. 

* Information is from qualitative research conducted by Doctor.One.

‍Coordination ofcare in the Doctor.One app .

In response to these challenges, we created a pilot project involving 10 neurology physicians and their MS patients, with the main goal of providing ongoing support and education about the disease and treatment through the Doctor.One app. Through the app, patients can reach out to their doctor with troubling symptoms or questions about the disease and treatment. Doctors, on the other hand, gained a place to remotely monitor the treatment process as a complement to inpatient visits. The new process of coordinating care with the inclusion of the Doctor.One app consisted of 3 components: 

‍Call forpatients

In the first phase of the project, the doctor invited 20 of his MS patients to join the platform, which allowed him to monitor the course of treatment on an ongoing basis and provide ongoing education.

‍Virtualtour

The doctor reserved two windows per week (about 30 minutes) in his calendar dedicated to so-called virtual rounds. During these sessions, he answered patients' ongoing questions and needs and proactively monitored the effects of treatment. Thanks to the feedback, the doctor was also able to modify treatment and decide on additional consultations (e.g. with a physiotherapist or psychologist) if necessary. 

‍Inspection visit

Regular quarterly inpatient visits were used for diagnostic activities, such as verifying the patient's physical fitness. Further education and ongoing monitoring took place via an app on rounds. 

‍Results ofthe pilot program

The pilot of the Doctor.One app brought significant benefits for both patients and attending physicians. Patients reported higher satisfaction with their care and a better understanding of their therapy and disease through more frequent micro-interactions with their doctor. Physicians, in turn, saw improvements in the effectiveness of therapy management and quality of care, thanks to regular contact and the ability to respond quickly to patients' needs. 

Integrating modern communication technologies into the treatment of chronic diseases like multiple sclerosis can significantly improve patient compliance with medical recommendations. By betting on the development of such solutions, we can raise the standards of medical care and its effectiveness in managing chronic diseases.

1. Rodis JL, Sevin A, Awad MH, et al. Improving Chronic Disease Outcomes Through Medication Therapy Management in Federally Qualified Health Centers. Journal of Primary Care & Community Health. 2017;8(4):324-331.

2. Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011 Apr;86(4):304-14. 

3. Yao, S., Lix, L., Teare, G., Evans, C., & Blackburn, D. (2022). An integrated continuity of care measure improves performance in models predicting medication adherence using population-based administrative data. PloS one, 17(3), e0264170. 

4. Koltuniuk A, Chojdak-Lukasiewicz J. Adherence to Therapy in Patients with Multiple Sclerosis-Review. International Journal of Environmental Research and Public Health. 2022; 19(4):2203.

5. Erbay Ö, Usta Yeşilbalkan Ö, Yüceyar N. Factors Affecting the Adherence to Disease-Modifying Therapy in Patients With Multiple Sclerosis. J Neurosci Nurs. 2018 Oct;50(5):291-297. 

6. Washington F, Langdon D. Factors affecting adherence to disease-modifying therapies in multiple sclerosis: a systematic review. J Neurol. 2022 Apr;269(4):1861-1872. 

7. Lenz F, Harms L. The Impact of Patient Support Programs on Adherence to Disease-Modifying Therapies of Patients with Relapsing-Remitting Multiple Sclerosis in Germany: A Non-Interventional, Prospective Study. Adv Ther. 2020 Jun;37(6):2999-3009.