Efficacy of a Telephone-Delivered Self-Management Intervention for Persons With Multiple Sclerosis: A Randomized Controlled Trial With a One-Year Follow-Up

Abstract Objective To evaluate the efficacy of a telephone-delivered self-management intervention for fatigue, pain, and depression in adults with multiple sclerosis (MS). Design Single-center, randomized (1:1), single-blind (outcome assessors), parallel-group trial with a primary endpoint of posttreatment (9–11wk postrandomization) and long-term follow-up at 6 and 12 months. Setting Telephone-delivered across the United States. Participants Adults with MS (N=163) with fatigue, chronic pain, and/or moderate depressive symptoms (age range, 25–76y). Interventions Eight-week individual telephone-delivered self-management intervention (T-SM) (n=75) versus an 8-week individual telephone-delivered MS education intervention (T-ED) (n=88). Main Outcome Measures The primary outcome was the proportion who achieved a ≥50% decrease in 1 or more symptoms—fatigue impact, pain interference, and/or depression severity. Secondary outcomes included continuous measures of pain, fatigue impact, depression, self-efficacy, activation, health-related quality of life, resilience, and affect. Results For our primary outcome, 58% of those in the T-SM group and 46% of those in the T-ED group had a ≥50% reduction in 1 or more symptoms; this difference was not statistically significant (odds ratio, 1.50; 95% confidence interval, .77–2.93; P =.238). Participants in both groups significantly improved from baseline to posttreatment in primary and secondary outcome measures ( P