eSupport: a feasibility RCT of internet-based support group participation to reduce loneliness in persons with multiple sclerosis
ECTRIMS Online Library. Leavitt V. 09/13/19; 278358; P1156
Victoria Leavitt
Victoria Leavitt
Contributions
Abstract

Abstract: P1156

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - MS symptoms

V. Leavitt, C. Riley, P. De Jager, S. Bloom

Neurology, Columbia University Irving Medical Center, New York, NY, United States

Introduction: Loneliness is a risk factor for morbidity and mortality, and interventions to reduce loneliness in persons with multiple sclerosis (pwMS) are lacking. This is of particular importance given a) the prevalence of disease-specific symptoms that put pwMS at higher increase risk for loneliness (e.g., physical disability, fatigue, depression, cognitive impairment), and b) evidence showing that the impact of loneliness on health may be mediated in part through dysregulation of inflammatory systems. Negative consequences of loneliness may therefore be accelerated and/or compounded by MS disease.
Objectives: To test a novel approach to support group delivery to reduce loneliness in pwMS: internet-based groups ('eSupport').
Aims: To conduct a feasibility RCT of internet-based support groups in pwMS.
Methods: This was a 12-week randomized, controlled feasibility trial of eSupport, video-link private, facilitated support groups to reduce loneliness in pwMS. Prior to enrolling our first participant, the trial was registered at ClinicalTrials.gov (NCT03574961). Thirty patients were enrolled; 24 completed baseline surveys and were randomized to eSupport (n=18) or active control condition: eJournal (n=10), structured online journaling (no social component). All participants were required to spend 1-hour per week engaged in online activities. Primary outcome was feasibility: our goal was 75% completion, 75% adherence. Preliminary efficacy evidence was measured as decrease in loneliness (total score on UCLA Loneliness Scale) and depressive symptoms [total score on Patient Healthy Questionnaire (PHQ-9)].
Results:
Feasibility outcomes were met: completion rate was 96.4%; 85.1% of completers were adherent. Regarding efficacy, eSupport participants' loneliness decreased by 2.6± 6.4 points versus 1.9± 7.5 points in eJournal; depression decreased by 1.6±2.8 points, compared to 0.3 ± 3.5 points after eJournal; differences were not statistically significant.
Concluions: Results support feasibility and initial efficacy of a completely remote intervention of internet-based support groups to reduce loneliness in pwMS. To our knowledge, this is the first clinical trial to quantify benefits of support group participation in MS.
Disclosure: Victoria M. Leavitt reports consulting work with Healios LLC.
Claire S. Riley reports consulting or advisory work with Biogen Idec, Celgene, Genentech/Roche, Genzyme, TG Therapeutics.
Philip De Jager is on the advisory board for the following: Celgene, Roche, Biogen, Genzyme, and has sponsored research agreements with Roche and Biogen.
Sharonna Bloom: nothing to disclose.
Study Funded: by the National Multiple Sclerosis Society (PP-1709-29158 to VML).

Abstract: P1156

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - MS symptoms

V. Leavitt, C. Riley, P. De Jager, S. Bloom

Neurology, Columbia University Irving Medical Center, New York, NY, United States

Introduction: Loneliness is a risk factor for morbidity and mortality, and interventions to reduce loneliness in persons with multiple sclerosis (pwMS) are lacking. This is of particular importance given a) the prevalence of disease-specific symptoms that put pwMS at higher increase risk for loneliness (e.g., physical disability, fatigue, depression, cognitive impairment), and b) evidence showing that the impact of loneliness on health may be mediated in part through dysregulation of inflammatory systems. Negative consequences of loneliness may therefore be accelerated and/or compounded by MS disease.
Objectives: To test a novel approach to support group delivery to reduce loneliness in pwMS: internet-based groups ('eSupport').
Aims: To conduct a feasibility RCT of internet-based support groups in pwMS.
Methods: This was a 12-week randomized, controlled feasibility trial of eSupport, video-link private, facilitated support groups to reduce loneliness in pwMS. Prior to enrolling our first participant, the trial was registered at ClinicalTrials.gov (NCT03574961). Thirty patients were enrolled; 24 completed baseline surveys and were randomized to eSupport (n=18) or active control condition: eJournal (n=10), structured online journaling (no social component). All participants were required to spend 1-hour per week engaged in online activities. Primary outcome was feasibility: our goal was 75% completion, 75% adherence. Preliminary efficacy evidence was measured as decrease in loneliness (total score on UCLA Loneliness Scale) and depressive symptoms [total score on Patient Healthy Questionnaire (PHQ-9)].
Results:
Feasibility outcomes were met: completion rate was 96.4%; 85.1% of completers were adherent. Regarding efficacy, eSupport participants' loneliness decreased by 2.6± 6.4 points versus 1.9± 7.5 points in eJournal; depression decreased by 1.6±2.8 points, compared to 0.3 ± 3.5 points after eJournal; differences were not statistically significant.
Concluions: Results support feasibility and initial efficacy of a completely remote intervention of internet-based support groups to reduce loneliness in pwMS. To our knowledge, this is the first clinical trial to quantify benefits of support group participation in MS.
Disclosure: Victoria M. Leavitt reports consulting work with Healios LLC.
Claire S. Riley reports consulting or advisory work with Biogen Idec, Celgene, Genentech/Roche, Genzyme, TG Therapeutics.
Philip De Jager is on the advisory board for the following: Celgene, Roche, Biogen, Genzyme, and has sponsored research agreements with Roche and Biogen.
Sharonna Bloom: nothing to disclose.
Study Funded: by the National Multiple Sclerosis Society (PP-1709-29158 to VML).

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