Abstract
Background
Cognitive difficulties are common in people with multiple sclerosis (pwMS), yet access to neuropsychological rehabilitation is often limited or only provided to those with more severe impairments. The NEuRoMS intervention provides brief, tailored neuropsychological rehabilitation for pwMS with mild-to-moderate cognitive difficulties.
Objectives
To evaluate feasibility and acceptability of the intervention and test procedures for a definitive trial.
Methods
A mixed-methods, multi-centre feasibility randomised controlled trial (RCT) was conducted. Feasibility outcomes were recruitment, retention, outcome completion, randomisation, intervention delivery and fidelity. Quantitative data were collected at baseline, 3- and 6-months, supplemented by interviews with pwMS and healthcare providers.
Results
Seventy-nine participants were randomised (mean age = 54.5 (SD = 11.5); 70% women) from three UK MS clinics. Most feasibility criteria were met: retention (>80%) and outcome-measure completion (81%–89%) were high, and trial procedures were acceptable. Intervention delivery was feasible and delivered as intended, but staffing-related recruitment challenges need addressing in future trials. Preliminary signal of efficacy was observed, with 3.42-point difference (effect size = 0.48) in the planned primary outcome (MS psychological impact) favouring the intervention, supported by qualitative evidence of sustained behaviour change.
Conclusion
The NEuRoMS intervention and trial procedures were feasible and acceptable, with early indication of efficacy. A definitive RCT is underway.