Education for fatigue management in people with multiple sclerosis: Systematic review and meta-analysis

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY European Journal of Neurology Pub Date : 2024-09-03 DOI:10.1111/ene.16452

Maria Janina Wendebourg, Jana Poettgen, Marcia Finlayson, Marien Gonzalez-Lorenzo, Christoph Heesen, Sascha Köpke, Andrea Giordano

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Abstract

Background and Purpose

Fatigue is a common and disabling symptom in multiple sclerosis (MS). Educational interventions have shown potential to reduce fatigue. The aim was to systematically review the current best evidence on patient education programmes for MS-related fatigue.

Methods

This was a systematic review and meta-analysis following Cochrane methodology. A systematic search was conducted in eight databases (September 2023). Moreover, reference lists and trial registers were searched and experts in the field were contacted. Randomized controlled trials were included evaluating patient education programmes for people with MS with the primary aim of reducing fatigue.

Results

In total, 1176 studies were identified and assessed by two independent reviewers; 15 studies (1473 participants) were included. All interventions provided information and education about different aspects of MS-related fatigue with different forms of application, some with components of psychological interventions. Amongst those, the most frequently applied were cognitive behavioural therapy (n = 5) and energy-conservation-based approaches (n = 4). Studies differed considerably concerning mode of intervention delivery, number of participants and length of follow-up. Interventions reduced fatigue severity (eight studies, n = 878, standardized mean difference −0.28; 95% confidence interval −0.53 to −0.03; low certainty) and fatigue impact (nine studies, n = 824, standardized mean difference −0.21; 95% confidence interval −0.42 to 0.00; moderate certainty) directly after the intervention. Mixed results were found for long-term effects on fatigue, for secondary endpoints (depressive symptoms, quality of life, coping) and for subgroup analyses.

Conclusion

Educational interventions for people with MS-related fatigue may be effective in reducing fatigue in the short term. More research is needed on long-term effects and the importance of specific intervention components, delivery and context.

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多发性硬化症患者的疲劳管理教育：系统回顾与荟萃分析。

背景和目的：疲劳是多发性硬化症（MS）常见的致残症状。教育干预已显示出减轻疲劳的潜力。本研究旨在系统回顾目前针对多发性硬化症相关疲劳的患者教育计划的最佳证据：这是一项采用 Cochrane 方法进行的系统回顾和荟萃分析。在八个数据库中进行了系统检索（2023 年 9 月）。此外，还检索了参考文献列表和试验登记册，并联系了该领域的专家。纳入的随机对照试验评估了以减轻疲劳为主要目标的多发性硬化症患者教育计划：结果：共确定了 1176 项研究，并由两名独立评审员进行了评估；纳入了 15 项研究（1473 名参与者）。所有干预措施都提供了与多发性硬化症相关的疲劳的不同方面的信息和教育，并采用了不同的应用形式，其中一些还包含心理干预的内容。其中，最常采用的是认知行为疗法（5 项）和节能方法（4 项）。在干预方式、参与人数和随访时间方面，研究结果存在很大差异。干预后可直接降低疲劳严重程度（8 项研究，n = 878，标准化平均差异 -0.28；95% 置信区间 -0.53 至 -0.03；低度确定性）和疲劳影响（9 项研究，n = 824，标准化平均差异 -0.21；95% 置信区间 -0.42 至 0.00；中度确定性）。在对疲劳的长期影响、次要终点（抑郁症状、生活质量、应对能力）和亚组分析方面，结果不一：结论：针对多发性硬化症相关疲劳患者的教育干预可能会在短期内有效减轻疲劳。结论：针对多发性硬化症相关疲劳患者的教育干预可在短期内有效减轻疲劳，但还需要对长期效果以及具体干预内容、实施方式和环境的重要性进行更多研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).