Medication self-management toolkits for adults with multiple sclerosis: A scoping review

Sara J T Guilcher; Lauren Cadel; Andrea He; Stephanie R Cimino; Maham Ahmed; Chester H Ho; Sander L Hitzig; Lisa M McCarthy; Tejal Patel; Shoshana Hahn-Goldberg; Aisha K Lofters; Tanya L Packer

doi:10.1016/j.rcsop.2023.100282

Medication self-management toolkits for adults with multiple sclerosis: A scoping review

Explor Res Clin Soc Pharm. 2023 May 23:10:100282. doi: 10.1016/j.rcsop.2023.100282. eCollection 2023 Jun.

Authors

Sara J T Guilcher^{1

2

3

4

5}, Lauren Cadel^{1

2}, Andrea He¹, Stephanie R Cimino^{1

3

4}, Maham Ahmed¹, Chester H Ho⁶, Sander L Hitzig^{3

4

7}, Lisa M McCarthy^{1

2

8

9

10}, Tejal Patel^{8

11}, Shoshana Hahn-Goldberg^{1

12}, Aisha K Lofters^{9

10}, Tanya L Packer^{13

14}

Affiliations

¹ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada.
² Institute for Better Health, Trillium Health Partners, Mississauga, Ontario L5B1B8, Canada.
³ Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada.
⁴ St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario M2M2G1, Canada.
⁵ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T3M6, Canada.
⁶ Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta T6G2G4, Canada.
⁷ Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada.
⁸ School of Pharmacy, University of Waterloo, Kitchener, Ontario N2G 1C5, Canada.
⁹ Department of Family and Community Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada.
¹⁰ Women's College Research Institute, Toronto, Ontario M5G1N8, Canada.
¹¹ Schlegel-University of Waterloo Research Institute of Aging, Waterloo, Ontario N2J0E2, Canada.
¹² OpenLab, University Health Network, Toronto, Ontario M5G2C4, Canada.
¹³ Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, Nova Scotia B3H4R2, Canada.
¹⁴ Department of Nursing, Umeå University, Umeå, Sweden.

Abstract

Background: Multiple sclerosis (MS) is an autoimmune disease that is often treated with multiple medications. Managing multiple medications, also known as polypharmacy, can be challenging for persons with MS. Toolkits are instructional resources designed to promote behaviour change. Toolkits may support medication self-management for adults with MS, as they have been useful in other populations with chronic conditions.

Objective: The main purpose of this review was to identify and summarize medication self-management toolkits for MS, as related to the design, delivery, components, and measures used to evaluate implementation and/or outcomes.

Methods: A scoping review was conducted following guidelines by JBI. Articles were included if they focused on adults (18 years or older) with MS.

Results: Six articles reporting on four unique toolkits were included. Most toolkits were technology-based, including mobile or online applications, with only one toolkit being paper-based. The toolkits varied in type, frequency, and duration of medication management support. Varying outcomes were also identified, but there were improvements reported in symptom management, medication adherence, decision-making, and quality of life. The six studies were quantitative in design, with no studies exploring the user experience from a qualitative or mixed-methods design.

Conclusions: There is limited research on medication self-management toolkits among adults with MS. Future development, implementation, and evaluation mixed-methods research are needed to explore user experiences and overall design of toolkits.

Keywords: Medication management; Medication self-management; Multiple sclerosis; Scoping review; Self-management; Toolkit.

Publication types

Review