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.