Intensive social cognitive treatment (can do treatment) with participation of support partners in persons with relapsing remitting multiple sclerosis: observation of improved self-efficacy, quality of life, anxiety and depression 1 year later

Abstract

BackgroundIn persons with multiple sclerosis (MS) self-efficacy positively affects health-related quality of life (HRQoL) and physical activity. In a previous study we observed that 6 months after an intensive 3-day social cognitive treatment (Can Do treatment) with the participation of support partners, self-efficacy and HRQoL had improved in persons with relapsing remitting MS (RRMS). Given the chronic nature of the disease, it is important to know whether these beneficial changes may last.MethodsCan Do treatment was given to 60 persons with MS and their support partners. At baseline and 12 months after treatment self-efficacy control, self-efficacy function, physical and mental HRQoL, anxiety, depression and fatigue were assessed via self-report questionnaires. Differences were tested via a paired t test.ResultsOf the 57 persons with MS that completed the baseline assessment and the 3-day treatment, 38 filled in the 12th month questionnaires (response rate 66.7 %), 22 with RRMS and 14 with progressive MS. In the RR group self-efficacy control had increased by 20.2 % and physical HRQoL by 15.0 %, and depression and anxiety had decreased by 29.8 and 25.9 %, respectively (all P < 0.05); the changes in mental HRQoL (+17 %) and fatigue (−20 %) failed to be statistically significant (P = 0.087, P = 0.080, respectively). In the progressive group no changes suggestive of improvement were seen.ConclusionsThe findings suggest that a 3-day intensive social cognitive treatment (Can Do treatment) with the participation of support partners may have long lasting beneficial effects on the self-efficacy and HRQoL in persons with RRMS; and that improvements in anxiety and depression, not seen in the 6-month study, may yet develop at 12 months.

An economic evaluation attached to a single-centre, parallel group, unmasked, randomized controlled trial of a 3-day intensive social cognitive treatment (can do treatment) in patients with relapsing remitting multiple sclerosis and low disability

“…After the baseline assessment (T0), follow-up assessments took place at 1 month (T1), 3 months (T2), and 6 months (T3). The 6-month follow up of the study was chosen as the observational study previously performed in MS patients with the same intervention in the Netherlands showed an effect after 6 months 15 . In addition, in a chronic disorder like MS, an effect shorter than 6 months would have limited clinical relevance.…”

“…4. CDT is a standardized intervention, which has been described in detail in order to make replication of the treatment and further research possible 15,16,19 . 5.…”

“…Other studies could not find a relevant difference between the treatment arms 8,11,13,14 . In the Netherlands, an intensive social cognitive theory-based intervention with the participation of supporting partners, the Can Do treatment (CDT), has been developed and evaluated through an uncontrolled observational study in patients with MS 15 . The results of this study were promising: at the 6 months follow-up, control self-efficacy (i.e.…”

“…Based on the promising results of the single-arm study 15 and the need for cost-effectiveness analyses, a randomized controlled study was designed to evaluate both the clinical and economic effectiveness of the CDT intervention as previously investigated 15,16 . The current trial-based economic evaluation aims to evaluate the cost-effectiveness from a societal perspective in patients with RRMS with low disability.…”

Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners

“… 6 In a subsequent study, it was found that 12 months after treatment, RRMS patients had an increased physical HRQoL (+15.0%) and decreased depression (−29.8%) and anxiety (−25.9%). 10 …”