Evaluation of software-based telephone counseling to enhance medication persistency among patients with multiple sclerosis.

OBJECTIVE

To evaluate the effect of a software-supported intervention based on the Transtheoretical Model of Change and motivational interviewing on decreasing discontinuation (or increasing persistency) of Avonex (interferon beta-1a--Biogen), a medication for treatment of multiple sclerosis (MS).

DESIGN

Randomized controlled experimental design comparison of software-based telephone counseling (intervention group) and standard care (control group).

SETTING

United States.

PARTICIPANTS

366 patients with MS.

INTERVENTION: Software-based telephone counseling.

MAIN OUTCOME MEASURE: Discontinuation of Avonex treatment and movement among stages of the Transtheoretical Model of Change.

RESULTS

Patients in the software intervention group demonstrated a statistically significantly lower proportion of Avonex treatment (1.2%) discontinuation than the standard care group (8.7%). In addition, stage movement away from discontinuation of Avonex (i.e., toward continuation of therapy) was significantly higher in the treatment group.

CONCLUSION

The Transtheoretical Model of Change constructs and motivational interviewing processes were effectively incorporated into a software-based intervention program, and this significantly decreased the proportion of patients who discontinued treatment of MS with Avonex. The integration of behavioral theory with information systems offers a promising approach for pharmacists and other providers to promote medication persistency.