{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:54:00Z","timestamp":1791914040506,"version":"4.3.4"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosdigitalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Digit Health"],"abstract":"<jats:p>\n                    <jats:italic>Brisa<\/jats:italic>\n                    , a companion app designed for multiple sclerosis (MS) patients, can support the patient journey by collecting longitudinal real-world data. This study aimed to characterize the demographic and clinical profile of Brisa users and longitudinal trends in app engagement, self-reported symptoms and patient-reported outcomes (PROs). This retrospective analysis included\n                    <jats:italic>Brisa<\/jats:italic>\n                    users aged \u226518 years, reported use of category 1 (low), 2 (medium), or 3 (high efficacy) disease-modifying therapy (DMT) according to German DGN guidelines, and had no medication switching. Users diagnosed within 0\u20131 years were classified as newly diagnosed cases. App engagement was defined as any screen activity; disengagement was defined as &gt;180 consecutive days without engagement and analysed using Cox proportional hazards regression. Symptoms were rated on a 1\u20135 emoticon-based scale (1\u2009=\u2009poor, 5\u2009=\u2009excellent). PROs included the MFIS, PDDS, PDQ-5, IVIS, and PES. Among 4,194 users, the majority were female (80.8%), aged 26\u201335 years (30.5%) and diagnosed with relapsing-remitting MS (77.4%), with 27.9% newly diagnosed. Consistent with a shift towards high-efficacy treatment, use of category 3 (high-efficacy) DMTs among newly diagnosed users significantly increased from 2023 to 2024\/2025 (\u03c7\n                    <jats:sup>2<\/jats:sup>\n                    , p\u2009&lt;\u20090.0001). In engagement analyses, users receiving category 3 DMTs, those aged \u226536 years, and newly diagnosed users showed a significantly lower risk of disengagement compared with users on category 1 DMTs, aged 18\u201325 years or diagnosed \u22652 years prior. Overall, about 76.0% of users tracked at least one symptom or PRO. Longitudinally, among users with \u22651 year of tracking, symptom and PRO scores remained largely stable. A shift toward higher efficacy treatment in newly diagnosed users was observed, while symptom and PRO scores remained largely stable over time. These findings highlight the potential of digital health tools for tracking treatment patterns, patient engagement and self-reported symptom changes in MS.\n                  <\/jats:p>","DOI":"10.1371\/journal.pdig.0001751","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:31:48Z","timestamp":1791912708000},"page":"e0001751","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["A longitudinal analysis of real world symptom tracking and patient-reported outcomes in Brisa, a German Digital Health App for multiple sclerosis"],"prefix":"10.1371","volume":"5","author":[{"given":"Ann-Sophie","family":"Stratil","sequence":"first","affiliation":[{"name":"Temedica GmbH","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffeni","family":"Papukchieva","sequence":"additional","affiliation":[{"name":"Temedica GmbH","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-6401","authenticated-orcid":true,"given":"Julia","family":"Steinmetz-Sp\u00e4h","sequence":"additional","affiliation":[{"name":"Temedica GmbH","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Joschko","sequence":"additional","affiliation":[{"name":"Roche Pharma AG","place":["Grenzach-Wyhlen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Masanneck","sequence":"additional","affiliation":[{"name":"Heinrich Heine University D\u00fcsseldorf","place":["D\u00fcsseldorf, Germany"],"department":["Department of Neurology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Temedica GmbH","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tjalf","family":"Ziemssen","sequence":"additional","affiliation":[{"name":"University Clinic Carl Gustav Carus and Dresden University of Technology","place":["Dresden, Germany"],"department":["Center of Clinical Neuroscience, Department of Neurology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"14","key":"pdig.0001751.ref001","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1177\/1352458520970841","article-title":"Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition","volume":"26","author":"C Walton","year":"2020","journal-title":"Mult Scler"},{"issue":"2","key":"pdig.0001751.ref002","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple sclerosis","volume":"378","author":"DS Reich","year":"2018","journal-title":"N 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Available from: www.dgn.org\/leitlinien"},{"issue":"4","key":"pdig.0001751.ref012","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S1474-4422(20)30067-3","article-title":"Timing of high-efficacy therapy for multiple sclerosis: A retrospective observational cohort study","volume":"19","author":"A He","year":"2020","journal-title":"Lancet Neurol"},{"issue":"1","key":"pdig.0001751.ref013","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s00415-023-11969-8","article-title":"Multiple sclerosis: Time for early treatment with high-efficacy drugs","volume":"271","author":"K Selmaj","year":"2024","journal-title":"J Neurol"},{"key":"pdig.0001751.ref014","doi-asserted-by":"crossref","first-page":"455","DOI":"10.2147\/PPA.S452849","article-title":"Preferences, adherence, and satisfaction: Three years of treatment experiences of people with multiple sclerosis","volume":"18","author":"O Hoffmann","year":"2024","journal-title":"PPA"},{"key":"pdig.0001751.ref015","doi-asserted-by":"crossref","DOI":"10.1177\/17562864241237857","article-title":"Shifting from the treat-to-target to the early highly effective treatment approach in patients with multiple sclerosis - 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