The direct benefit of neuropsychological assessment with feedback in multiple sclerosis

Title
A randomised control trial of the direct psychological benefit of neuropsychological assessment with feedback in comparison to a wait-list control group in patients with multiple sclerosis and their caregivers

Type of intervention
Neuropsychological assessment/treatment

Form of MS
All

Brief summary
Background: Cognitive impairment is one of the most common symptoms in multiple sclerosis (MS), being objectively confirmed on neuropsychological assessment in at least 50% of patients. It can be functionally disabling, and has been shown to significantly impact on patients’ capacity to function in most domains of life, including personal self-care, mental health and mood, relationships, social and leisure activities, rehabilitation, driving, and employment. Cognitive impairment can also impact upon families and caregivers. In particular, MS patient cognitive impairment has been found to be significantly associated with caregiver distress, quality of life, and caregiver strain. The rehabilitation of cognitive impairment in MS is still in its infancy, and although neuropsychological assessment is often described as the first step in the rehabilitation of cognitive impairment, it can also be a form of therapeutic intervention in its own right. However, research into the direct therapeutic benefit of neuropsychological assessment as a rehabilitative intervention in MS is very limited. So, using a randomised-controlled-trial approach, the present study aims to investigate the direct psychological benefit of neuropsychological assessment with feedback in patients with MS and their main caregivers immediately following the feedback session and up to 10 weeks later. It is proposed that the intervention will lead to an increase in patient and caregiver knowledge of the patient’s cognitive strengths and weaknesses, to an improvement in the patient’s use of adaptive psychological strategies for coping with the health problems caused by MS, and to more positive caregiving outcomes for the caregiver.

Intervention: The main components include: a clinical interview, the administration of objective, psychometric tests and observation of behaviour during testing, & interpretation of the results, followed by collaborative discussion of results and their practical implications with patients and caregivers, and agreeing upon recommendations for management.

The intervention is delivered by qualified and experienced clinical neuropsychologists. It takes approximately 8-10 hours, and is spread over 2-3 face-to-face sessions (typically 2 sessions for the assessment and 1 for the feedback discussion) over a period of 1 - 2 weeks. It is delivered 6-7 weeks after randomisation.

Inclusion criteria
MS diagnosed by a neurologist
Registered as a client with MS Australia – ACT/NSW/VIC
Referral to the clinical neuropsychological assessment service for a non-urgent assessment for addressing current clinical concerns
Patients do not have to have a caregiver to participate.
Open to both males and females
Minimum age: 16 (no maximum)

Exlusion criteria:
History of a developmental intellectual disability
Severe cognitive impairment, including suspected MS-related dementia
Significantly impaired hearing despite use of prescribed hearing aids or other equipment
Impaired command of English due to non-English speaking background or aphasia
Severe dysarthria or significantly impaired voice volume
Current severe psychiatric impairment (e.g. severe depression, anxiety, or psychosis)
Impaired ability to manage the practical requirements of the study, such as an unstable medical or health condition causing delirium or hospitalizations, or a lack of reliable access to a telephone and mailbox due to unstable accommodation and/or support arrangements

Anticipated start date/Recruitment status
Recruiting

Recruitment contacts
Patients will only be recruited into this trial following referral to the clinical neuropsychological assessment service by a health professional

Further details
This project has been funded by MS Research Australia - further details of the project can be found here

This trial is registered on the Australian New Zealand Clinical Trials Registry. For the full record click here

Region
NSW

Trial results

Last updated: 6 February 2012