Evaluation of the effectiveness of professionally guided self-care for people with multiple sclerosis living in the community: a randomized controlled trial.

OBJECTIVE: The aim of the study was to assess the efficacy of a patient-focused professionally guided self-care programme for the management of multiple sclerosis (MS) in the community. DESIGN: This was a single-blind randomized controlled trial. SETTING: The study was conducted with people with MS living in the community. PARTICIPANTS: Two hundred and seventy-eight people with MS were invited to take part in the study. One hundred and eighty-nine people consented to take part (68%). Of these 183 began the study and 169 (92.3%) completed it. Seventy-three individuals were in the intervention group and 96 were in the control group. INTERVENTION: The intervention comprised discussion of self-care based on client priorities, using an information booklet about self-care. MAIN OUTCOME MEASURES: These included the Barthel Index, a measure of mobility, the SF-36, and the Standard Day Dependency Record (SDDR) which measures the need for assistance with daily activities. Assessments were conducted at baseline and again six months later. RESULTS: Changes in health status were small. However, at follow-up the intervention group had better SF-36 health scores, in mental health (p = 0.04), and vitality (p = 0.05) and considered help with daily activities to be less essential, as measured by the SDDR (p = 0.04), than the control group. Participants in the intervention group had maintained levels of independence at follow-up (p = 0.62) while the control group showed a significant decrease in independence (p= 0.001). CONCLUSION: This intervention could be a useful aid for health professionals who are supporting people with MS living in the community.

Evaluation of education for people with osteoarthritis of the knee: recruitment and retention issues in study design.

Osteoarthritis (OA) is a common and often disabling condition affecting older adults. Treatment using anti-inflammatory drugs (NSAIDs) often contributes to morbidity ( 1 ). It is a common reason for people seeking help from primary care ( 2 ). However, unfortunately management approaches often reflect the ageist view that OA is an inevitable consequence of ageing.