title: A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue.
abstract: The majority of people affected by Multiple Sclerosis (paMS) experience severe and disabling fatigue. A recent randomised controlled trial (RCT) showed that cognitive behaviour therapy with a clinical psychologist was an effective treatment for MS fatigue. An Internet-based version of this intervention, MS Invigor8, was developed for the current study using agile design and input from paMS. MS Invigor8 includes eight tailored, interactive sessions. The aim was to test the feasibility and potential efficacy and cost-effectiveness of the programme in a pilot RCT. 40 patients were randomised to MS Invigor8 (n=23) or standard care (n=17). The MS Invigor8 group accessed sessions over 8-10 weeks and received up to three 30-60min telephone support sessions. Participants completed online standardised questionnaires assessing fatigue, mood, quality of life and service use at baseline and 10 weeks follow-up. Large between group treatment effects were found for the primary outcomes of fatigue severity (d=1.19) and impact (d=1.02). The MS Invigor8 group also reported significantly greater improvements in anxiety, depression and quality-adjusted life years. These data suggest that Internet-based CBT may be a clinically and cost-effective treatment for MS fatigue. A larger RCT with longer term follow-up is warranted.
authors.affiliation: Psychology Dept., Institute of Psychiatry, KCL, London, UK. rona.moss-morris@kcl.ac.uk
authors.forename: Rona
authors.initials: R
authors.lastname: Moss-Morris
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
authors.forename: Kirsten
authors.initials: K
authors.lastname: van Kessel
authors.forename: Gary
authors.initials: G
authors.lastname: Wills
authors.forename: Laura
authors.initials: L
authors.lastname: Dennison
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D005221:Fatigue / Q000191:economics / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000191:economics; D010349:Patient Compliance; D017060:Patient Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D019114:Remote Consultation / Q000379:methods*; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome