Telemedical communication patterns in myasthenia gravis in a remote monitoring study.

Abstract

Purpose: Myasthenia gravis (MG) is a rare neuromuscular disease. In-person appointments in specialized centers are not readily available, especially on short notice. The purpose of this study was to analyze patient-specialist communication through a telemedical platform.

Methods: In a randomized controlled study 45 MG patients were observed over three months. The intervention group (N = 30) was monitored via a mobile application ('app') that enabled chat function and assessed MG -specific outcome measures and data from external devices. We quantitatively evaluated communication patterns for patients and specialists from the chat. Controls (N = 15) received standard of care. Perceived MG specialist accessibility and contact with physicians outside the study team regarding MG-related issues was assessed in both groups.

Findings: In total, MG specialists were contacted a median of six times per patient via the chat, most commonly regarding medical issues (151, 54.5%), followed by technical (70, 25.3%), organizational (53, 19.1%), and other (3, 1.1%) topics. Specialists initiated contact a median of eight times per patient, most frequently addressing medical concerns (190, 49.4%), 38.4% of which were recommendations for medication changes. Specialists also addressed technical (154, 40.0%), organizational (36, 9.4%) and other (5, 1.3%) issues. Contacts with physicians outside the study team did not differ between groups. Perceived specialist accessibility was rated higher with telemedical support by the intervention group.

Conclusion: MG patients have a notable demand for timely advice especially concerning treatment recommendations. Future studies should evaluate the potential of telemedical solutions to prevent worsening of symptoms.

Trial registration: The study was registered under DRKS00029907 on August 19, 2022.