Developing and piloting a web based interactive self-management programme for the treatment of multiple sclerosis fatigue

Fatigue is a common, distressing and disabling symptom associated with multiple sclerosis (MS). Up to 97% of people with MS experience fatigue as part of their illness. We have recently completed a 3 year randomised controlled trial using 8 sessions of manualised cognitive behavioural therapy (CBT) to treat fatigue in MS. The treatment appeared to be very effective. At 6 months post treatment, not only had fatigue substantially reduced, but people with MS reported levels of fatigue that were significantly lower than those of a matched healthy, non-fatigued comparison group. However, a limitation of this therapy package is that skilled CBT therapists are not available to many people with MS due to lack of available resources and difficulty of access. There is now a growing body of literature demonstrating that internet delivered CBT together with minimal therapist time (around a 100 minutes of either face-to-face, telephone or email contact) can be as effective as CBT where people meet with a therapist for weekly or fortnightly sessions. The purpose of this innovation grant is to develop and pilot an Internet based version of this CBT package, which if shown to be successful has the potential to be rolled out across the UK as an approach for people with MS to manage and treat their fatigue. The study will incorporate a collaborative approach between health and clinical psychologists, people with MS, information technologists and a health economist.