Article

OBJECTIVE: To evaluate the efficacy of a telephone-delivered self-management
intervention for fatigue, pain, and depression in adults with multiple sclerosis (MS). DESIGN: Single-center, randomized (1:1), single-blind (outcome assessors),
parallel-group trial with a primary endpoint of posttreatment (9-11 wk
postrandomization) and long-term follow-up at 6 and 12 months. SETTING: Telephone-delivered across the United States.
PARTICIPANTS: Adults with MS
(N=163) with fatigue, chronic pain, and/or moderate depressive symptoms (age
range, 25-76 y). INTERVENTIONS: Eight-week individual telephone-delivered
self-management intervention (T-SM) (n=75) versus an 8-week individual
telephone-delivered MS education intervention (T-ED)
(n=88). MAIN OUTCOME
MEASURES: The primary outcome was the proportion who achieved a >/=50% decrease
in 1 or more symptoms-fatigue impact, pain interference, and/or depression
severity. Secondary outcomes included continuous measures of pain, fatigue
impact, depression, self-efficacy, activation, health-related quality of life,
resilience, and affect. RESULTS: For our primary outcome, 58% of those in the
T-SM group and 46% of those in the T-ED group had a >/=50% reduction in 1 or more
symptoms; this difference was not statistically significant (odds ratio, 1.50;
95% confidence interval, .77-2.93; P=.238). Participants in both groups
significantly improved from baseline to posttreatment in primary and secondary
outcome measures (P<.05).
T-SM participants reported significantly higher
treatment satisfaction and therapeutic alliance and greater improvements in
activation, positive affect, and social roles. Improvements were generally
maintained at 6 and 12 months. CONCLUSIONS: Both interventions resulted in short-
and long-term, clinically meaningful benefits.
The study demonstrated that the
telephone is an effective method for engaging participants in care and extending
the reach of rehabilitation for individuals with MS.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS