February 27, 2019 A Cognitive self-management intervention for persons with multiple sclerosis Janet Morrison, PhD, RN, MSCN Research Associate V Research.

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Presentation transcript:

February 27, 2019 A Cognitive self-management intervention for persons with multiple sclerosis Janet Morrison, PhD, RN, MSCN Research Associate V Research reported here was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number P30NR015335. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Background Chronic immune-mediated degenerative disease of the CNS Prevalence ~ 900,000 in US 3:1 Female to male ratio Variable and unpredictable symptoms Fatigue Depression Sleep disturbance Mobility Impaired cognitive function Significant impact on maintaining employment, self-management, QoL

Study Design Pilot RCT Intervention (n=8) Enhanced usual care (n=8) 8 weekly 90-minute virtual group sessions Self-Management Chronic Disease and Cognitive Function Remote, web-based video conferencing Enhanced usual care (n=8) Introduction – tell their stories Physical Activity Fatigue, Sleep and Nutrition Stress Management & Depression Attention & Processing Speed Learning & Memory Executive Function & Visiospatial Skills Putting it All Together

Sample (N=16) Age (years) 56 + 9.9 Female 15 (94%) White 14 (88%) Non-Hispanic Married 12 (75%) Highly educated (> Bachelors degree) 11 (69%) Relapsing-Remitting course 12 (75%)

Outcomes Self-Report Performance MS self-management Self-efficacy Managing medications, symptoms and daily activities Cognitive function Depression Fatigue Sleep disturbance Performance Neuropsych Language Executive function Attention Working and episodic memory Processing speed Physiologic Physical activity Sleep Self-Report – PROMIS and Neuro-QoL Neuropsych Performance – NIH Toolbox Physiologic Performance – Actigraphy

Web-based video conferencing Attendance (mean = 7 + .92) Proof of Concept Web-based video conferencing Attendance (mean = 7 + .92) Positive participant feedback Couldn’t have participated: BARRIERS Mobility, fatigue, transportation, traffic

Strengths & Limitations Small sample size (N=16) Variability Lack of power Intensity of intervention Versus dissertation study 6 months, 2 times/week, supervised exercise

Next Steps Comparative effectiveness trial More sensitive outcome measures Repeated measures design

THANK YOU