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

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 (CC) 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. (C) 2009 Elsevier Ireland Ltd. All rights reserved.