Neuropsychological evaluation and rehabilitation in multiple sclerosis (NEuRoMS): protocol for a mixed-methods, multicentre feasibility randomised controlled trial.

Cognition Cognitive screening Feasibility study Multiple sclerosis Randomised controlled trial Rehabilitation

Journal

Pilot and feasibility studies
ISSN: 2055-5784
Titre abrégé: Pilot Feasibility Stud
Pays: England
ID NLM: 101676536

Informations de publication

Date de publication:
11 Jun 2022
Historique:
received: 13 11 2021
accepted: 17 05 2022
entrez: 11 6 2022
pubmed: 12 6 2022
medline: 12 6 2022
Statut: epublish

Résumé

Cognitive problems affect up to 70% of people with multiple sclerosis (MS), which can negatively impact mood, ability to work, and quality of life. Addressing cognitive problems is a top 10 research priority for people with MS. Our ongoing research has systematically developed a cognitive screening and management pathway (NEuRoMS) tailored for people with MS, involving a brief cognitive evaluation and rehabilitation intervention. The present study aims to assess the feasibility of delivering the pathway and will inform the design of a definitive randomised controlled trial (RCT) to investigate the clinical and cost-effectiveness of the intervention and eventually guide its clinical implementation. The feasibility study is in three parts. Part 1 involves an observational study of those who receive screening and support for cognitive problems, using routinely collected clinical data. Part 2 is a two-arm, parallel group, multicentre, feasibility RCT with a nested fidelity evaluation. This part will evaluate the feasibility of undertaking a definitive trial comparing the NEuRoMS intervention plus usual care to usual care only, amongst people with MS with mild cognitive problems (n = 60). In part 3, semi-structured interviews will be undertaken with participants from part 2 (n = 25), clinicians (n = 9), and intervention providers (n = 3) involved in delivering the NEuRoMS cognitive screening and management pathway. MS participants will be recruited from outpatient clinics at three UK National Health Service hospitals. Timely screening and effective management of cognitive problems in MS are urgently needed due to the detrimental consequences of cognitive problems on people with MS, the healthcare system, and wider society. The NEuRoMS intervention is based on previous and extant literature and has been co-constructed with relevant stakeholders. If effective, the NEuRoMS pathway will facilitate timely identification and management of cognitive problems in people with MS. ISRCTN11203922 . Prospectively registered on 09.02.2021.

Sections du résumé

BACKGROUND BACKGROUND
Cognitive problems affect up to 70% of people with multiple sclerosis (MS), which can negatively impact mood, ability to work, and quality of life. Addressing cognitive problems is a top 10 research priority for people with MS. Our ongoing research has systematically developed a cognitive screening and management pathway (NEuRoMS) tailored for people with MS, involving a brief cognitive evaluation and rehabilitation intervention. The present study aims to assess the feasibility of delivering the pathway and will inform the design of a definitive randomised controlled trial (RCT) to investigate the clinical and cost-effectiveness of the intervention and eventually guide its clinical implementation.
METHODS METHODS
The feasibility study is in three parts. Part 1 involves an observational study of those who receive screening and support for cognitive problems, using routinely collected clinical data. Part 2 is a two-arm, parallel group, multicentre, feasibility RCT with a nested fidelity evaluation. This part will evaluate the feasibility of undertaking a definitive trial comparing the NEuRoMS intervention plus usual care to usual care only, amongst people with MS with mild cognitive problems (n = 60). In part 3, semi-structured interviews will be undertaken with participants from part 2 (n = 25), clinicians (n = 9), and intervention providers (n = 3) involved in delivering the NEuRoMS cognitive screening and management pathway. MS participants will be recruited from outpatient clinics at three UK National Health Service hospitals.
DISCUSSION CONCLUSIONS
Timely screening and effective management of cognitive problems in MS are urgently needed due to the detrimental consequences of cognitive problems on people with MS, the healthcare system, and wider society. The NEuRoMS intervention is based on previous and extant literature and has been co-constructed with relevant stakeholders. If effective, the NEuRoMS pathway will facilitate timely identification and management of cognitive problems in people with MS.
TRIAL REGISTRATION BACKGROUND
ISRCTN11203922 . Prospectively registered on 09.02.2021.

Identifiants

pubmed: 35690797
doi: 10.1186/s40814-022-01073-5
pii: 10.1186/s40814-022-01073-5
pmc: PMC9187894
doi:

Types de publication

Journal Article

Langues

eng

Pagination

123

Subventions

Organisme : National Institute for Health Research
ID : RP-PG-0218-20002

Informations de copyright

© 2022. The Author(s).

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Auteurs

Gogem Topcu (G)

Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.

Laura Smith (L)

School of Psychology, Keynes College, University of Kent, Canterbury, Kent, UK.

Jacqueline R Mhizha-Murira (JR)

Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.

Nia Goulden (N)

North Wales Organisation for Randomised Trials in Health Clinical Trials Unit, Bangor University, Bangor, UK.

Zoë Hoare (Z)

North Wales Organisation for Randomised Trials in Health Clinical Trials Unit, Bangor University, Bangor, UK.

Avril Drummond (A)

School of Health Sciences, University of Nottingham, Nottingham, UK.

Deborah Fitzsimmons (D)

Swansea Centre for Health Economics, School of Health and Social Care, Faculty of Medicine, Health and Life Sciences, Swansea University, Swansea, UK.

Nikos Evangelou (N)

Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Klaus Schmierer (K)

Centre for Neuroscience, Surgery and Trauma, Barts and the London School of Medicine and Dentistry, The Blizard Institute, Queen Mary University of London, London, UK.
Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK.

Emma C Tallantyre (EC)

Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.
Department of Neurology, Cardiff and Vale University Health Board, Cardiff, UK.

Paul Leighton (P)

Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.

Kimberley Allen-Philbey (K)

Centre for Neuroscience, Surgery and Trauma, Barts and the London School of Medicine and Dentistry, The Blizard Institute, Queen Mary University of London, London, UK.
Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK.

Andrea Stennett (A)

Wolfson Institute of Population Health, Queen Mary University of London, London, UK.

Paul Bradley (P)

Department of Neurology, Cardiff and Vale University Health Board, Cardiff, UK.

Clare Bale (C)

Multiple Sclerosis Patient and Public Involvement Group, Nottingham, UK.

James Turton (J)

Multiple Sclerosis Patient and Public Involvement Group, Nottingham, UK.

Roshan das Nair (R)

Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK. roshan.dasnair@nottingham.ac.uk.
Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK. roshan.dasnair@nottingham.ac.uk.

Classifications MeSH