title: One year follow-up of a pragmatic multi-centre randomised controlled trial of a group-based fatigue management programme (FACETS) for people with multiple sclerosis.
abstract: BACKGROUND
  Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS). The aim was to evaluate the effectiveness at 1-year follow-up of a manualised group-based programme ('FACETS') for managing MS-fatigue.
  
  
  METHODS
  One-year follow-up of a pragmatic multi-centre randomised controlled trial. People with MS and significant fatigue were randomised to FACETS plus current local practice (FACETS) or current local practice alone (CLP), using concealed computer-generated randomisation. Participant blinding was not possible. Primary outcome measures were fatigue severity (Global Fatigue Severity subscale of the Fatigue Assessment Instrument), self-efficacy (MS-Fatigue Self-Efficacy) and disease-specific quality of life (MS Impact Scale).
  
  
  RESULTS
  Between May 2008 and November 2009, 164 participants were randomised. Primary outcome data were available at 1 year for 131 (80%). The benefits demonstrated at 4-months in the FACETS arm for fatigue severity and self-efficacy largely persisted, with a slight reduction in standardised effect sizes (SES) (-0.29, p = 0.06 and 0.34, p = 0.09, respectively). There was a significant difference on the MS Impact Scale favouring FACETS that had not been present at 4-months (SES -0.24, p = 0.046). No adverse events were reported.
  
  
  CONCLUSIONS
  Improvements in fatigue severity and self-efficacy at 4-months follow-up following attendance of FACETS were mostly sustained at 1 year with additional improvements in MS impact. The FACETS programme provides modest long-term benefits to people with MS-fatigue.
  
  
  BACKGROUND
  ISRCTN76517470.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Thomas
authors.affiliation: Clinical Research Unit, School of Health and Social Care, Bournemouth University, Bournemouth BH1 3LT, UK. saraht@bournemouth.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Thomas
authors.forename: Paula
authors.initials: P
authors.lastname: Kersten
authors.forename: Rosemary
authors.initials: R
authors.lastname: Jones
authors.forename: Vicky
authors.initials: V
authors.lastname: Slingsby
authors.forename: Alison
authors.initials: A
authors.lastname: Nock
authors.forename: Angela
authors.initials: A
authors.lastname: Davies Smith
authors.forename: Roger
authors.initials: R
authors.lastname: Baker
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Galvin
authors.forename: Charles
authors.initials: C
authors.lastname: Hillier
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012648:Self Care; D020377:Self Efficacy; D016896:Treatment Outcome; D055815:Young Adult