Artikel
Interactive web platform for emPOWERment in early Multiple Sclerosis (POWER@MS1) – multiphase mixed methods study evaluating the effect of a complex behaviour change intervention on inflammatory disease activity
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Veröffentlicht: | 25. September 2020 |
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Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system, which is often diagnosed in young adulthood [1]. After an MS diagnosis, uncertainty and psychological stress may negatively affect the disease course, while psychological counselling may reduce inflammatory activity [2]. The complex behaviour change intervention “levidex” in POWER@MS1 offers intensive and individualized support for newly diagnosed persons with MS (pwMS) through evidence-based patient information (EBPI) on immunotherapy decision making, disease management and lifestyle choices.
Research question and objectives: This study investigates the hypothesis that a complex behaviour change intervention in combination with EBPI can reduce inflammatory disease activity in MS, measured clinically or by MRI, and change patient behaviour. The intervention aims to help pwMS to deal with the disease and to initiate lifestyle changes. Ideally, POWER@MS1 allows a more targeted initiation of immunotherapy and an optimization of lifestyle habits related to stress, sleep, nutrition and exercise.
Methods: The intervention was developed as part of a multiphase mixed methods study. It was pretested with experts and pwMS to examine practicability (i.e. navigation, composition, clarity) and acceptance (i.e. transparent and understandable evidence communication, motivational incentives, appropriateness of examples and patient experiences). After a first revision based on the acquired feedback, the programme was piloted with pwMS. Subsequent to a final revision, the intervention is currently evaluated against optimized standard care in a multicentre randomized controlled trial (RCT) aiming to recruit 328 patients with relapsing-remitting MS in the first year after diagnosis. In addition, a mixed methods process evaluation and a health economic evaluation is carried out.
Results: The pretest with 15 pwMS and 6 MS experts indicated good comprehensibility, relevance and trustworthiness of the intervention programme. Participants of the pilot phase (n=8) reported a good level of satisfaction with the programme as well as high relevance for newly diagnosed patients. Some pwMS already initiated or planned to initiate lifestyle changes due to participation in the pilot phase. Detailed feasibility data will be presented.
Discussion: POWER@MS1 is the first study to investigate the effects of a complex behaviour change intervention in combination with EBPI on inflammatory disease activity in MS.
Practical implications: If successful, POWER@MS1 has a groundbreaking potential to change guidelines on MS care, enabling lifestyle management a firm place as active MS treatment.
References
- 1.
- Petersen G, Wittmann R, Arndt V, Göpffarth D. Epidemiologie der Multiplen Sklerose in Deutschland : Regionale Unterschiede und Versorgungsstruktur in Abrechnungsdaten der gesetzlichen Krankenversicherung [Epidemiology of multiple sclerosis in Germany: regional differences and drug prescription in the claims data of the statutory health insurance]. Nervenarzt. 2014 Aug;85(8):990-8. DOI: 10.1007/s00115-014-4097-4
- 2.
- Artemiadis AK, Anagnostouli MC, Alexopoulos EC. Stress as a risk factor for multiple sclerosis onset or relapse: a systematic review. Neuroepidemiology. 2011;36(2):109-20. DOI: 10.1159/000323953