1
|
Tuvemo Johnson S, Flink M, Peterson E, Gottberg K, Elf M, Johansson S, Kierkegaard M, Ytterberg C. Self-management of falls in people with multiple sclerosis: A scoping review. Clin Rehabil 2023; 37:162-176. [PMID: 36177511 PMCID: PMC9772893 DOI: 10.1177/02692155221128723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Falls are common in people with multiple sclerosis. There is rising interest in how the multifactorial and chronic nature of fall risk among people with multiple sclerosis can be addressed through self-management. Thus, the aims were to investigate the extent and the scope of publications on self-management of falls in people with multiple sclerosis, and to identify how the concept of self-management was defined and used. DATA SOURCES A systematic literature search in Medline, Cochrane, Web of Science and PsycInfo was conducted to identify publications until July 2022. REVIEW METHODS Published methodological guidance was followed. Articles targeting: (1) people with multiple sclerosis, (2) falls, and (3) self-management were selected. Of 1656 records, 203 publications were assessed for eligibility, of which 173 did not meet the inclusion criteria, and 16 publications did not contain empirical data. The type of publication, study focus, and study design was extracted. If applicable, key findings, self-management tasks and skills, and the definition of self-management were extracted. RESULTS Fourteen original articles met all inclusion criteria. Ten articles represented six different fall prevention interventions. Three publications were randomized controlled trials. Self-management content was variable and not comprehensive in nature. None of the 14 publications included a self-management definition. CONCLUSION The limited number of original articles and the even fewer intervention studies show that the research on self-management of falls in people with multiple sclerosis is in its infancy. To progress in the research area of self-management of falls, a more robust, consensus-based description of self-management frameworks and activities is needed.
Collapse
Affiliation(s)
- Susanna Tuvemo Johnson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,Susanna Tuvemo Johnson, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Alfred Nobells allé 23, S-14183 Huddinge, Sweden.
| | - Maria Flink
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,Women’s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Elizabeth Peterson
- Department of Occupational Therapy, University of Illinois, Chicago, IL, USA
| | - Kristina Gottberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Marie Elf
- School of Education and Learning, Dalarna University, Falun, Sweden
| | - Sverker Johansson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,Women’s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Marie Kierkegaard
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,Academic Specialist Center, Center of Neurology, Stockholm Health Services, Stockholm, Sweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,Women’s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
2
|
Davis BE, Lakin L, Binns CC, Currie KM, Rensel MR. Patient and Provider Insights into the Impact of Multiple Sclerosis on Mental Health: A Narrative Review. Neurol Ther 2021; 10:99-119. [PMID: 33877584 PMCID: PMC8056993 DOI: 10.1007/s40120-021-00240-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/03/2021] [Indexed: 12/12/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic disease in which the immune system attacks the central nervous system, causing inflammation and neurodegeneration. People living with MS may experience a variety of symptoms as a consequence of this process, including many “invisible” symptoms that are internally manifested and not seen by others. Of the invisible symptoms of MS, which we have reviewed in a companion article, mood and mental health disorders are of particular concern due to their high prevalence and significant impact on patient quality of life. In this review, we showcase the experiences of patient authors alongside perspectives from healthcare provider authors as we promote awareness of the common mental health conditions faced by those living with MS, such as depression, anxiety, adjustment disorder, bipolar disorder, psychosis, and suicidal ideation. Many of these conditions stem in part from the increased stress levels and the many uncertainties that come with managing life with MS, which have been exacerbated by the environment created by the coronavirus disease 2019 (COVID-19) pandemic. A patient-centered interdisciplinary approach, routine screening for mental health changes, and referral to specialists when needed can normalize discussions of mental health and increase the likelihood that people living with MS will receive the support and care they need. Management techniques such as robust social support, cognitive behavioral therapy, mindfulness-based interventions, and/or pharmacotherapy may be implemented to build resilience and promote healthy coping strategies. Increasingly, patients have access to telehealth options as well as digital apps for mental health management. Taken together, these approaches form an integrative care model in which people living with MS benefit from the care of medical professionals, a variety of support networks/resources, and self-management techniques for optimal mental health care. ![]()
Collapse
Affiliation(s)
- Bryan E Davis
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA
| | - Lynsey Lakin
- The Neurology Group, 9120 Haven Ave, Rancho Cucamonga, CA, USA.,The University of California Riverside, Comprehensive MS Center, 3390 University Ave, Suite 100, Riverside, CA, USA
| | - Cherie C Binns
- Accelerated Cure Project/iConquerMS, 187 Robinson Street, Wakefield, RI, USA
| | - Keisha M Currie
- Currie Consultancy Agency LLC., 11 M. R. Watson Court, Eastover, SC, USA
| | - Mary R Rensel
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA.
| |
Collapse
|
3
|
Yahno NN, Fedotova AV. Post-marketing observational program of the effectiveness of fluvoxamine for the treatment of depression in patients with neurological disorders: the FRIENDS study. Neuropsychiatr Dis Treat 2017; 13:2747-2756. [PMID: 29138569 PMCID: PMC5679672 DOI: 10.2147/ndt.s145614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In a prospective, non-blinded, uncontrolled, multicenter, post-marketing, observational study (FRIENDS; NCT02043197), fluvoxamine (50-300 mg/day for 90 days) was effective for the treatment of depression in 299 adult patients (age ≥18 years) with neurological disorders at baseline. The therapeutic effect of fluvoxamine was measured by means of changes in the Hospital Anxiety and Depression Scale depression and anxiety scores (HADS-D and HADS-A, respectively), global severity of illness, and clinical condition (measured using the Clinical Global Improvement [CGI] scale). The mean HADS-D subscale score at baseline in the per-protocol cohort (n=296) was 11.7±3.1 points and the corresponding mean HADS-A score was 12.6±3.2. Significant (P<0.0001) improvements in both scores were recorded during fluvoxamine treatment and later follow-up. Most patients (>85%) recorded reductions versus baseline in both indices. In the CGI-based assessment, most evaluated patients (>200) experienced moderate to very substantial clinical improvement, with no or limited side effects. Significant improvements were also recorded in the exploratory outcomes of sleep quality, assessed using the Insomnia Severity Index, and cognitive function, assessed using the Montreal Cognitive Assessment (P<0.0001 vs baseline for both). No death or serious adverse drug reactions were reported during the study. The results of this observational study affirm that fluvoxamine is effective and well tolerated for the treatment of depression in the context of neurological disorders. The effects on the exploratory endpoints of this research merit evaluation in controlled trials.
Collapse
Affiliation(s)
- Nikolay N Yahno
- Neurology Department, I.M. Sechenov First Moscow State Medical University
| | - Anastasia V Fedotova
- Neurology Department, Additional Professional Education Faculty, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| |
Collapse
|