Two Researchers Investigate FACETS Program to Fight Fatigue in MS

Throughout the years, Dr. Sarah Thomas and Dr. Peter Thomas at Bournemouth University have been developing a program to aid multiple sclerosis patients affected by fatigue. Their program, developed at the Bournemouth University Clinical Research Unit in collaboration with colleagues at Dorset Multiple Sclerosis Service at Poole Hospital, is a group-based fatigue management program called “Fatigue: Applying Cognitive behavioral and Energy effectiveness Techniques to lifeStyle” (FACETS).

Recently, the research team tested the validity of the Multiple Sclerosis-Fatigue Self-Efficacy scale with patients enrolled in a clinical trial for FACETS. Published in Clinical Rehabilitation, the article, “The Multiple Sclerosis-Fatigue Self-Efficacy  (MS-FSE) Scale: Initial Validation,” found that the scale can detect changes in multiple sclerosis patients’ fatigue level within the FACETS program and is internally valid. “The MS-FSE scale (8-item) demonstrated good sensitivity to change following attendance of the FACETS program,” wrote Dr. Sarah Thomas, lead author on the study.

These results were gathered by evaluating the validity, internal consistency, and sensitivity to change for the MS-FSE in 164 patients with multiple sclerosis in the FACETS program. At the beginning of the study, patients completed 9 items of the MS-FSE, and repeated the task at one, four, and twelve months post-intervention. Few (6%) could answer item 3 of the evaluation, as few knew other individuals with multiple sclerosis.

The program itself, FACETS, was developed to address the problem of fatigue in multiple sclerosis patients. Writing in Journal of Neurology, Neurosurgery, and Psychiatry, Dr. Sarah Thomas stated the goal was “to evaluate the effectiveness and cost-effectiveness of a six-session group-based program for managing multiple sclerosis-fatigue (FACETS).” The article, “A Pragmatic Parallel Arm Multi-centre Randomised Controlled Trial to Assess the Effectiveness and Cost-Effectiveness of a Group-based Fatigue Management Programme (FACETS) for People with Multiple Sclerosis,” compiled data for 146 of the 164 enrolled patients.

FACETS is structured around weekly groups sessions led by two heath professionals experienced in cognitive behavioral approaches. The group performs flipchart exercises, receives instruction on tasks to do at home, and listens to presentations and group discussions. By taking control of fatigue, patients in the trial hope to restore their energy levels, which are diminished by the progressive nature of multiple sclerosis.

After analyzing the trial data, the researchers found that just one week of enrollment in FACETS led to significant differences in fatigue relative to baseline. ” FACETS is effective in reducing fatigue severity and increasing fatigue self-efficacy,” stated Dr. Sarah Thomas.

Following up one year later, Dr. Peter Thomas wrote an update on the trial and published in BMC Neurology under the title, “One Year Follow-up of a Pragmatic Multi-centre Randomised Controlled Trial of a Group-based Fatigue Management Programme (FACETS) for People with Multiple Sclerosis.” For the most part, achievements in fatigue severity and self-efficacy were maintained between the 4-month follow-up and one year later.

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