Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). A recent randomized controlled trial (RCT) showed a self-management program for fatigue and a general MS education program that controlled for time and attention had equivalent effects on reducing fatigue impact in adults with MS.
Examine moderators of treatment-related improvements in fatigue impact following self-management and education interventions in adults with MS.
Secondary analysis of a recent RCT (N=218) using multilevel modeling to assess moderators of treatment improvements in fatigue impact through six-month follow-up. Hypothesized moderators included age, gender, cohabitation with or without a spouse/partner, MS subtype (relapsing-remitting MS or progressive MS) as well as baseline depression symptoms, sleep disturbance, and self-efficacy.
Living with or without a spouse/partner moderated intervention effects on fatigue impact through the six-month follow-up (b = -0.23, t(588) = 2.09, p = .04; controlling for MS subtype and income). The findings suggested that, in the fatigue self-management group, participants living with a spouse/partner showed greater improvement in fatigue impact (within group Cohen’s d = 0.55) compared to participants who did not live with a spouse/partner (d = 0.14). However, in the general MS education group, improvements in fatigue impact were similar between participants living with a spouse/partner (d = 0.23) and those who did not live with a spouse/partner (d = 0.50). Age, gender, MS subtype and baseline depression symptoms, sleep disturbance, and self-efficacy did not moderate treatment effects on fatigue impact.
Although the findings are exploratory, this study emphasizes that the presence of a close relationship may facilitate benefit from self-management interventions for MS-related fatigue. Future research should investigate how to promote engaging supportive others in self-management interventions for MS-related fatigue.