A randomised controlled trial of lay-led self-management for people with multiple sclerosis

Patient Educ Couns. 2009 Oct;77(1):81-9. doi: 10.1016/j.pec.2009.02.009. Epub 2009 Mar 24.

Abstract

Objective: To determine the impact of the Chronic Disease Self-Management Course (CDSMC) on people with multiple sclerosis (MS).

Methods: 2-group, randomised, controlled trial with Intervention Group (IG) and Waiting-List Control Group (WLCG). Additional data were collected from a Comparison Group (CG) who chose not to attend the CDSMC. Participants completed baseline questionnaires; IG participants attended the CDSMC immediately; all participants were assessed at 4-months and 12-months.

Results: 216 baseline questionnaires were returned; 73% were female, mean age 51.1 years, mean disease duration 12.0 years. Results showed that the CDSMC had an impact on self-management self-efficacy (ES 0.30, p=0.009 for the IG) and MSIS physical status (ES 0.12 for the IG, p=0.005). There were no other statistically significant changes. However, trends towards improvement on depression (ES 0.21 for the IG, p=0.05) and MS self-efficacy (ES 0.16 for the IG, p=0.04) were noted. All improvements were maintained at 12-months. At baseline, CG participants were older, had longer disease duration (p<0.01) and less anxiety (p=0.009) compared to RCT participants.

Conclusion: The CDSMC provides some small positive effects for people with MS. Motivation to attend may be linked to psychological distress and disease duration.

Practice implications: The CDSMC may be of value for those with mild anxiety/depression who need extra support. Attendance early in the disease course is recommended.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Analysis of Variance
  • Anxiety / prevention & control*
  • Depression / prevention & control*
  • Diet
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Multiple Sclerosis*
  • Pain Measurement
  • Psychometrics
  • Self Care*
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Waiting Lists