American journal of physical medicine & rehabilitation | 2021
Moderators of Improvements in Fatigue Impact Following a Self-Management Intervention in Multiple Sclerosis: A Secondary Analysis of a Randomized Controlled Trial.
Abstract
ABSTRACT\nFatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). A recent randomized controlled trial comparing a fatigue self-management program and a general MS education program found that both programs improved fatigue in participants with MS. Participants were randomized to a self-management program (Fatigue: Take Control, n = 109) or an MS education program (MS: Take Control, n = 109). This secondary analysis of that trial used multilevel moderation analysis to examine moderators of treatment-related effects on fatigue (Modified Fatigue Impact Scale) from baseline through the 6-month follow-up. The following potential treatment moderators were examined: age, sex, cohabitation/marital status, and baseline levels of self-efficacy, depression symptoms, and sleep quality. Cohabitation status (living with or without a spouse/partner) interacted with intervention group and time to predict fatigue impact (p = .04). Fatigue: Take Control participants who lived with a spouse/partner showed a marginal effect in greater rate of improvement in fatigue compared to those who lived alone (p = .08). However, rates of improvement in fatigue in MS: Take Control participants were similar in those living with or without a spouse/partner. These findings suggest that living with a spouse or partner may facilitate benefit from self-management interventions for MS-related fatigue. Future research should investigate the contribution of supportive others in self-management of fatigue in MS.