Improvement in depressive symptoms is associated with sustained improvement in fatigue impact in adults with multiple sclerosis.

Background: Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). Behavioral interventions that target one or more behaviors such as sleep hygiene, exercise, energy management, cognitive processes, as well as mood have been shown to reduce fatigue in people with MS. Yet, little is known about mechanisms of intervention effects on MS fatigue.

Appointment non-attendance is associated with disease modifying therapy persistence the following year.

Background: It is recommended that healthcare providers and persons with multiple sclerosis (MS) have discussions prior to discontinuing a disease modifying therapy (DMT). However, if these appointments missed, either as a no show (NS) or short-notice cancellation (SNC), these discussions do not take place and may result in premature discontinuation. This study aimed to explore whether appointment non-attendance was predictive of DMT persistence the following year.

Improving prospective memory in persons with multiple sclerosis via telehealth: A randomized feasibility study.

Background: Persons with multiple sclerosis (PwMS) can experience deficits in prospective memory (PM) or "remembering to remember," which are associated with functional difficulties. However, no cognitive rehabilitation intervention has specifically addressed improving PM in PwMS. The Telehealth PM Intervention (TPMI) provides a novel combination of two strategies-visual imagery and implementation intentions-that have each been beneficial in other populations.

Processing speed and memory test performance are associated with different brain region volumes in Veterans and others with progressive multiple sclerosis.

Background: Cognitive dysfunction and brain atrophy are both common in progressive multiple sclerosis (MS) but are seldom examined comprehensively in clinical trials. Antioxidant treatment may affect the neurodegeneration characteristic of progressive MS and slow its symptomatic and radiographic correlates.

Objectives: This study aims to evaluate cross-sectional associations between cognitive battery components of the Brief International Cognitive Assessment for Multiple Sclerosis with whole and segmented brain volumes and to determine if associations differ between secondary progressive (SPMS) and primary progressive (PPMS) MS subtypes.

Risk Factors for Chronic Prescription Opioid Use in Multiple Sclerosis.

Objective: To characterize patterns of prescription opioid use among individuals with multiple sclerosis (MS) and identify risk factors associated with chronic use.

Design: Retrospective longitudinal cohort study examining US Department of Veterans Affairs electronic medical record data of Veterans with MS. The annual prevalence of prescription opioid use by type (any, acute, chronic, incident chronic) was calculated for each study year (2015-2017).

Using participatory action research to develop a new self-management program: Results from the design stage of Managing My MS My Way.

Background: Self-management programs have been used with success in several clinical populations, and there is a growing body of evidence to support their use among persons with multiple sclerosis (MS). This group aimed to develop a novel self-management program, Managing My MS My Way (MW), which is based in social cognitive theory and contains evidence-based strategies that have been shown to be effective for persons with MS. Furthermore, persons with MS would serve as stakeholders throughout the development process to ensure that the program would be useful and encourage adoption.

Appointment attendance behaviors in multiple sclerosis: Understanding the factors that differ between no shows, short notice cancellations, and attended appointments.

Background: There has yet to be an examination of how appointment attendance behaviors in multiple sclerosis (MS) are related to scheduling metrics and certain demographic, clinical, and behavioral factors such as cognitive functioning and personality traits. This study aimed to examine the factors that differ between no shows (NS), short notice cancellations (SNC), and attended appointments.

Methods: Participants (n = 110) were persons with MS who were enrolled in a larger cross-sectional study, during which they completed a battery of neuropsychological measures.

Comorbidities as predictors of all-cause emergency department utilization among veterans with multiple sclerosis.

Background: While comorbidities have been associated with all-cause hospitalizations among persons with multiple sclerosis (MS), there has been no examination of their role in all-cause emergency department (ED) utilization. As such, this study aimed to determine if the presence of comorbidities increases the odds of ED usage in a national sample of Veterans with MS.

Methods: Data were extracted retrospectively from the Veterans Affairs (VA) MS Center of Excellence Data Repository, an electronic health record-based dataset.

Demographic and Clinical Factors Are Associated With Frequent Short-Notice Cancellations in Veterans With Multiple Sclerosis on Disease Modifying Therapies.

Objectives: (1) To identify the rate of short-notice canceled appointments in a large national sample of persons with multiple sclerosis (MS) and (2) examine the demographic and clinical factors associated with frequent cancellations.

Design: Retrospective cross-sectional cohort using electronic health records.

Setting: Veterans Health Administration.

Mobile health (mHealth) usage, barriers, and technological considerations in persons with multiple sclerosis: a literature review.

Objectives: Persons with multiple sclerosis (MS) can face a number of potential healthcare-related barriers, for which mobile health (mHealth) technology can be potentially beneficial. This review aimed to understand the frequency, current uses, and potential barriers with mHealth usage among persons with MS.

Methods: A query string was used to identify articles on PubMed, MEDLINE, CINAHL, and IEEE Xplore that were published in English between January 2010 and December 2019.

Moderators of Improvements in Fatigue Impact After a Self-management Intervention in Multiple Sclerosis: A Secondary Analysis of a Randomized Controlled Trial.

Fatigue is one of the most common and disabling symptoms of multiple sclerosis. A recent randomized controlled trial comparing a fatigue self-management program and a general multiple sclerosis education program found that both programs improved fatigue in participants with multiple sclerosis. Participants were randomized to a self-management program (fatigue: take control, n = 109) or a multiple sclerosis education program (multiple sclerosis: take control, n = 109).

Risk Factors for Suboptimal Medication Adherence in Persons With Multiple Sclerosis: Development of an Electronic Health Record-Based Explanatory Model for Disease-Modifying Therapy Use.

Objective: To determine which factors are associated with suboptimal disease-modifying therapy (DMT) adherence and to develop an explanatory model that could be used to identify individuals at risk and potentially inform interventions.

Design: Cross-sectional cohort study using electronic health records.

Setting: Veterans Health Administration (VA).

Who is not coming to clinic? A predictive model of excessive missed appointments in persons with multiple sclerosis.

Background: Missed appointments can have negative effects on several facets of healthcare, including disruption of services, worse patient health outcomes, and increased costs. The influence of demographic and clinical factors on missed appointments has been studied in a number of chronic conditions, but not yet in multiple sclerosis (MS). Engagement in healthcare services is a particular concern with this population, given the complexity of the condition.

Physical activity and depression in MS: The mediating role of behavioral activation.

Background: Depression is a common comorbid condition among individuals with multiple sclerosis (MS) and is associated with greater overall disease burden and lower quality of life. Numerous clinical trials have supported physical activity interventions versus education, usual care, and attention control conditions for improving depressive symptoms in individuals with MS. However, little is known about the psychological mechanisms that may underlie physical activity-related improvements in depression.

Pilot randomized trial of a telephone-delivered physical activity and weight management intervention for individuals with lower extremity amputation.

Background: Obesity and inactivity are common and burdensome for people with lower extremity amputation (LEA). The extent to which home-based physical activity/weight management programs are effective and safe for people with LEA is unknown. Translating effective interventions for understudied disability groups is needed.

This is your new normal: A qualitative study of barriers and facilitators to physical activity in Veterans with lower extremity loss.

Background: Regular physical activity (PA) is essential for aging well with a disability, preventing the onset or worsening of chronic conditions, functional loss, and maintaining or improving quality of life, yet PA levels are low in those with disabilities, including those with a lower extremity amputation (LEA).

Objective: To determine methods for promoting PA in this population, our objective was to better understand the barriers and facilitators to PA that persons with LEA face.

Methods: Semi-structured interviews were conducted with male Veterans with a LEA.

Sleep and its associations with perceived and objective cognitive impairment in individuals with multiple sclerosis.

Problems with sleep and cognitive impairment are common among people with multiple sclerosis (MS). The present study examined the relationship between self-reported sleep and both objective and perceived cognitive impairment in MS. Data were obtained from the baseline assessment of a multi-centre intervention trial (NCT00841321).

Mental Health Comorbidity in MS: Depression, Anxiety, and Bipolar Disorder.

Among individuals with multiple sclerosis (MS), mental health comorbidities play a significant role in contributing to secondary disability and detracting from quality of life. This review examines current evidence surrounding three mental health issues of particular relevance to MS: depression, anxiety, and bipolar disorder. We review what is known of the prevalence, correlates, screening mechanisms, and current treatment of each issue and provide recommendations for future areas of research.

Improving fatigue and depression in individuals with multiple sclerosis using telephone-administered physical activity counseling.

Objective: To evaluate the impact of a physical activity intervention consisting of telephone counseling with home-based monitoring to improve fatigue and depression in individuals with multiple sclerosis (MS).

Method: Single-blind randomized controlled trial. Sixty-four individuals with MS received either telephone counseling (N = 31), or self-directed physical activity education (N = 33).

Summary of comprehensive systematic review: Rehabilitation in multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

Objective: To systematically review the evidence regarding rehabilitation treatments in multiple sclerosis (MS).

Methods: We systematically searched the literature (1970-2013) and classified articles using 2004 American Academy of Neurology criteria.

Results: This systematic review highlights the paucity of well-designed studies, which are needed to evaluate the available MS rehabilitative therapies.