A six-week cognitive behavioural programme, followed by four periodic refresher sessions can help alleviate fatigue for people with multiple sclerosis (MS) for at least twelve months, new research in France has found.
This programme can be delivered by a range of healthcare professionals and be easily implemented in national health systems.
In 2010, a team from 裸聊直播 developed the FACETS programme. This consists of six once-weekly group sessions where people learn lifestyle tips聽and ways of maximising their available energy, along with helpful ways of thinking about fatigue. A clinical trial in 2013 demonstrated its effectiveness in improving people鈥檚 fatigue levels. It has since been implemented globally, including in Norway and Australia.
This new French clinical trial, published in the , built on feedback from FACETS鈥� participants that they would like 鈥榖ooster鈥� sessions to be available at the end of the programme to help them to sustain momentum.聽Booster sessions have been used successfully in programmes for other long-term conditions.
Dr Sarah Thomas from 裸聊直播鈥檚 Clinical Research Unit led the development of the original FACETS programme and was involved in the new trial, led by CHIPS Site Hospitalier de Poissy in France.
鈥淔atigue is a huge issue for people with MS. It鈥檚 highly debilitating and been shown to play a key role in determining quality of life. It鈥檚 the main reason why people with MS stop working early or reduce their hours,鈥� Dr Thomas explained.
鈥淎s it鈥檚 an invisible symptom that can vary from one day to the next or even throughout the day, it鈥檚 incredibly frustrating and challenging and can be difficult for others to understand,鈥� she added.
In the clinical trial, 105 people with relapsing-remitting MS were randomly allocated to receive either the original manualised FACETS group programme plus standard care or standard care only. In addition, those allocated to FACETS were offered 4 in-person 鈥榖ooster鈥� group sessions in the 12 months following the 6-week programme (FACETS+). The booster sessions provided an opportunity to revisit key principles and strategies, discuss progress and challenges faced, make plans, and share experiences and successes.
Participants in both groups completed self-reported symptom questionnaires throughout the trial.
The results showed significant improvements in self-reported fatigue at up to one year for those who had received FACETS+ compared to the control group.
Professor Marie-Claire Gay, a聽clinical psychologist from Paris-Nanterre University,聽who led the development of the booster sessions, remarked, 鈥淚t鈥檚 encouraging that, as hoped, the addition of booster sessions based on psychological theory helped to sustain the benefits of the original FACETS programme in the longer-term.鈥�
Dr Olivier Heinzlef, a neurologist at CHIPS Site Hospitalier de Poissy, with clinical oversight of the trial, commented, 鈥淚n France MS patients often receive little or no support for fatigue, so a programme like FACETS+ that can be easily implemented in current practice addresses a huge unmet need.鈥�
Dr Thomas added, 鈥淚t鈥檚 fantastic not only to see the success of the booster sessions but the transfer of the programme to a French healthcare context.鈥�
The FACETs programme is being developed further to increase its capacity to be delivered digitally. FACETS 鈥榟omework鈥� tasks are currently undertaken in a paper form and include keeping an activity diary, creating sleep and rest routines, identifying and challenging unhelpful thoughts related to fatigue, and setting fatigue management and lifestyle goals.
Dr Sarah Thomas and Professor Huseyin Dogan have recently received funding from Multiple Sclerosis Research Treatment and Education (MSRTE) charity to undertake further development and evaluation of a mobile app that gives people the option to complete these tasks on their mobile phone.
