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MS-DOS er et forprosjekt som undersøker muligheter for at personer med multippel sklerose (MS) og relevante helseaktører kan ta i bruk digitale hjelpemidler for bedre oppfølging, behandling og mestring av sykdommen. Målet for MS-DOS er å samle informasjon om hvilke utfordringer personer med MS opplever på grunn av sin sykdom, og vurdere i hvilken grad digitale verktøy kan gjøre livet bedre for denne gruppen. Denne rapporten gir et overblikk over helsetilbudet til personer med MS. Deretter presenteres resultater fra en dybdestudie hvor vi følger tre personer med MS over en periode på seks uker. Metoden vi har brukt er observasjon og intervjuer, samt kartlegging av planlagte og reelle pasientforløp ved hjelp av Customer Journey Modelling Language. Rapporten presenterer til slutt muligheter for bruk av digitale støtteverktøy, og forslag til videre studier Oppdragsgiver: Helsedirektoratet ved Innomed

Background: Several environmental exposures, including infection with Epstein-Barr virus, low levels of vitamin D and smoking are established risk factors for multiple sclerosis (MS). Also, high hygienic standard and infection with parasites have been proposed to influence MS risk. The aim of this study was to investigate the influence of various environmental exposures on MS risk in a Norwegian cohort, focusing on factors during childhood related to the hygiene hypothesis. Methods: A questionnaire concerning environmental exposures, lifestyle, demographics and comorbidity was administrated to 756 Norwegian MS patients and 1090 healthy controls. Logistic regression was used to calculate odds ratio (OR) with 95% confidence interval (CI) for the risk of MS associated with the variables infectious mononucleosis, severe infection during childhood, vaccination and animals in the household during childhood. Age, gender, HLA-DRB1*15:01, smoking and infectious mononucleosis were included as covariates. General environmental exposures, including tobacco use, were also evaluated. Results: Infectious mononucleosis was confirmed to be significantly associated with increased MS risk, also after adjusting for the covariates (OR?=?1.79, 95% CI: 1.12-2.87, p?=?0.016). The controls more often reported growing up with a cat and/or a dog in the household, and this was significant for ownership of cat also after adjusting for the covariates (OR?=?0.56, 95% CI: 0.40-0.78, p?=?0.001). More patients than controls reported smoking and fewer patients reported snuff use. Conclusions: In this Norwegian MS case-control study of environmental exposures, we replicate that infectious mononucleosis and smoking are associated with increased MS risk. Our data also indicate a protective effect on MS of exposure to cats during childhood, in accordance with the hypothesis that risk of autoimmune diseases like MS may increase with high hygienic standard.