Randomised controlled trial of a self-guided online fatigue intervention in multiple sclerosis
Open accessAbstract
OBJECTIVE: Fatigue is a major disabling symptom in many chronic diseases including multiple sclerosis (MS), but treatment options are limited.Here, we tested the effectiveness of a self-guided , interactive, online fatigue management programme (ELEVIDA) based on principles of cognitive behavioural therapy (CBT) and related psychotherapeutic approaches (eg, mindfulness) for reducing fatigue in MS. METHODS: Patients with MS and self-reported fatigue were recruited via the website of the German MS Society and assigned via an automated randomisation generator (1:1, no blocking or stratification) to a 12-week online intervention (ELEVIDA, n=139, 82% female, mean age 40.8, median patient determined disease steps (PDDS) 3.0) or a waitlist control group (n=136, 79% female, mean age 41.9, median PDDS 3.0). The primary outcome was the Chalder Fatigue Scale. Outcomes were assessed at baseline, at week 12 (postintervention) and at follow-up (week 24). RESULTS: Compared with the control group, significantly greater reductions in Chalder Fatigue Scale scores were seen in the ELEVIDA group at week 12 (primary endpoint, intention-to-treat analysis: between-group mean difference 2.74 points; 95% CI 1.16 to 4.32; p=0.0007; effect size d=0.53), with effects sustained at week 24 (intention-to-treat analysis: between-group mean difference 2.19 points; 95% CI 0.57 to 3.82; p=0.0080). CONCLUSIONS: Our trial provides evidence for the effectiveness of a self-guided , internet-based intervention to reduce fatigue in MS. Interventions such as ELEVIDA may be a suitable low barrier, cost-effective treatment option for MS fatigue. TRIAL REGISTRATION NUMBER: ISRCTN registry (number ISRCTN25692173).
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Several studies have demonstrated that online CBT-based fatigue management programs are a cost-effective and accessible treatment option for pwMS.
“Several studies have demonstrated that online CBT-based fatigue management programs are a cost-effective and accessible treatment option for pwMS (Pottgen et al., 2018;Moss-Morris et al., 2012;van den Akker et al., 2017).”
From Neuropsychology intervention for managing invisible symptoms of MS (NIMIS-MS) group: A pilot effectiveness and acceptability study (2024) · cites this paper as Pottgen et al., 2018
The Abstract (p. 3) reports that the online CBT-based program reduced fatigue in people with MS, and the Discussion (pp. 12–13) describes its potential reach and low barriers to access. But the paper says such programs *may* be cost-effective; it does not demonstrate cost-effectiveness. The claim presents that possibility as an established finding. (LLM, conf=0.88)
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- Authors
- Pöttgen, J., Moss-Morris, R., Wendebourg, J.-M., Feddersen, L., Lau, S., Köpke, S., Meyer, B., Friede, T., Penner, I.-K., Heesen, C., & Gold, S. M.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- King's College London (GB)
- University of Lübeck (DE)
- City, University of London (GB)
- Universitätsmedizin Göttingen (DE)
- Life Science Center Düsseldorf (Germany) (DE)
- Humboldt-Universität zu Berlin (DE)
- Corresponding author
- Gold, Stefan M
- ORCID
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2018-03-16
- Volume
- 89
- Issue
- 9
- Pages
- 970-976
- ISSN
- 0022-3050 (ISSN-L)
- 1468-330X
- OpenAlex
- W2790285286
- Cited by
- 129
- References
- 39
- Citations by year
- 2026: 19 · 2025: 22 · 2024: 19 · 2023: 23 · 2022: 16 · 2021: 15 · 2020: 8 · 2019: 6 · 2018: 1
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- other-oa
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Gemeinnützige Hertie-Stiftung
- Deutsche Forschungsgemeinschaft
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- multiple sclerosis, fatigue, online intervention, self-guided intervention, cognitive behavioral therapy, mindfulness, Chalder Fatigue Scale, online therapy, waitlist control
- MeSH terms
- Adult, Fatigue, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Patient Compliance, Self Care, Cognitive Behavioral Therapy, Internet, Self Report
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