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A randomised controlled trial of lay-led self-management for people with multiple sclerosis [with consumer summary]
Barlow J, Turner A, Edwards R, Gilchrist M
Patient Education and Counseling 2009 Oct;77(1):81-89
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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.
With permission from Excerpta Medica Inc.

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