Improving Confidence of RRMS Patients May Enhance Quality of Life, Decrease Depression, Study Finds

Increasing a person’s confidence that they can complete tasks and reach goals in specific situations may benefit patients with relapsing-remitting multiple sclerosis (RRMS).

In a new study, researchers used an intensive three-day social cognitive treatment, called Can Do, to increase patients’ self-efficacy, which resulted in long lasting improvements in their health-related quality of life (HRQoL).

The study, “Intensive social cognitive treatment (can do treatment) with participation of support partners in persons with relapsing remitting multiple sclerosis: observation of improved self-efficacy, quality of life, anxiety and depression 1 year later,” was published in BMC Research Notes.

Self-efficacy is a psychological concept that is known to affect people’s behavior in a number of ways. Believing in our ability to perform certain tasks or to reach certain objectives determines how we deal with the difficulties of such tasks. Specifically, a person tends to avoid tasks where self-efficacy is low, and is more likely to feel discouraged and to give up when performing them as they believe the task is harder than it actually is, which may also be associated with increased stress. People with high self-efficacy tend to undertake tasks and persist longer.

In patients with chronic diseases such as multiple sclerosis, the increasing disability affects patients’ independence, which in turn affects their self-efficacy. In such patients, a decrease in self-efficacy is correlated with a reduction in physical activity, as well as a reduction in physical and mental quality of life. Patients with lower self-efficacy are therefore more likely to experience depression.

Several treatment modalities designed to increase self-efficacy in patients with chronic conditions have shown beneficial results. In a previous study, researchers reported that the Can Do treatment, a three-day intensive program that helps patients identify and reduce stressors in the performance of specific tasks, relying on the participation of the patient’s support partners, could increase self-efficacy control in RRMS patients six months after treatment, which was accompanied by an increase in mental and physical HRQoL.

However, given the chronic nature of MS, the researchers were interested in assessing whether the Can Do treatment could maintain these improvements long-term. They explored the effects of the Can Do treatment in both RRMS and progressive MS patients one year after treatment.

Results showed that in RRMS patients the treatment significantly improved self-efficacy in 20.2 percent, which led to a significant increase in physical HRQoL by 15 percent. Importantly, the treatment induced a 29.8 percent decrease in depression, and a 25.9 percent decrease in anxiety, two effects that had not been seen at the six-month follow-up.

Although it also increased mental HRQoL and decreased fatigue, the results were not statistically significant. In addition, patients with progressive MS did not show any improvements.

The findings suggest that the Can Do treatment is a good approach to improve self-efficacy in RRMS patients on a long-term basis, and that some improvements that are not seen in earlier time-points, such as anxiety and depression, may develop at 12 months.