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

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.