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Health outcomes and adherence to a healthy lifestyle after a multimodal intervention in people with multiple sclerosis: Three year follow-up.
PLoS One 2018; 13(5):e0197759Plos

Abstract

BACKGROUND

Modifiable risk factors such as smoking and sedentary lifestyle adversely affect multiple sclerosis (MS) progression. Few multimodal behavioural interventions have been conducted for people with MS, and follow-up beyond 1 year is rare for lifestyle interventions. This study assessed adoption and adherence to healthy lifestyle behaviours and health outcomes 3 years after a lifestyle modification intervention, using generalized estimating equation models to account for within-participant correlation over time.

METHODS

95 people with MS completed baseline surveys before participating in 5-day MS lifestyle risk-factor modification workshops. 76 and 78 participants completed the 1-year and 3-year follow-up surveys respectively. Mean age at 3-year follow-up was 47 years, 72% were female, most (62.8%) had MS for 5 years or less, and 73% had relapsing remitting MS (RRMS).

RESULTS

Compared to baseline, participants reported clinically meaningful increases in physical (mean difference (MD): 8.0, 95% Confidence Interval (CI): 5.2-10.8) and mental health (MD: 9.2, CI: 5.8-12.6) quality of life (QOL) at 1-year, and physical (MD: 8.7, CI: 5.3-12.2) and mental health (MD: 8.0, CI: 4.2-11.8) QOL at 3-year follow-up. There was a small decrease in disability from baseline to 1-year follow-up (MD: 0.9, CI: 0.9,1.0) and to 3-year follow-up (MD: 1.0, CI: 0.9,1.0), which was not clinically meaningful. Of those with RRMS, compared to baseline, fewer had a relapse during the year before 1-year follow-up (OR: 0.1, CI 0.0-0.2) and 3-year follow-up (OR: 0.15, CI 0.06-0.33). Participants' healthy diet score, the proportion meditating ≥1 hours a week, supplementing with ≥ 5000IU vitamin D daily, and supplementing with omega-3 flaxseed oil increased at 1-year follow-up and was sustained, although slightly lower at 3-year follow-up. However, there was no evidence for a change in physical activity and not enough smokers to make meaningful comparisons. Medication use increased at 1-year follow-up and at 3-year follow-up.

CONCLUSION

The results provide evidence that lifestyle risk factor modification is feasible and sustainable over time, in a small self-selected and motivated sample of people with MS. Furthermore, participation in a lifestyle intervention is not associated with a decrease in MS medication use.

Authors+Show Affiliations

Neuroepidemiology Unit, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia. Disability and Health, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia.Neuroepidemiology Unit, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia.Neuroepidemiology Unit, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia.Neuroepidemiology Unit, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia.Neuroepidemiology Unit, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia.Neuroepidemiology Unit, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia.City of Whittlesea, Victoria, Australia.Neuroepidemiology Unit, the Melbourne School of Population and Global Health, the University of Melbourne, Victoria, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29791509

Citation

Marck, Claudia H., et al. "Health Outcomes and Adherence to a Healthy Lifestyle After a Multimodal Intervention in People With Multiple Sclerosis: Three Year Follow-up." PloS One, vol. 13, no. 5, 2018, pp. e0197759.
Marck CH, De Livera AM, Brown CR, et al. Health outcomes and adherence to a healthy lifestyle after a multimodal intervention in people with multiple sclerosis: Three year follow-up. PLoS ONE. 2018;13(5):e0197759.
Marck, C. H., De Livera, A. M., Brown, C. R., Neate, S. L., Taylor, K. L., Weiland, T. J., ... Jelinek, G. A. (2018). Health outcomes and adherence to a healthy lifestyle after a multimodal intervention in people with multiple sclerosis: Three year follow-up. PloS One, 13(5), pp. e0197759. doi:10.1371/journal.pone.0197759.
Marck CH, et al. Health Outcomes and Adherence to a Healthy Lifestyle After a Multimodal Intervention in People With Multiple Sclerosis: Three Year Follow-up. PLoS ONE. 2018;13(5):e0197759. PubMed PMID: 29791509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health outcomes and adherence to a healthy lifestyle after a multimodal intervention in people with multiple sclerosis: Three year follow-up. AU - Marck,Claudia H, AU - De Livera,Alysha M, AU - Brown,Chelsea R, AU - Neate,Sandra L, AU - Taylor,Keryn L, AU - Weiland,Tracey J, AU - Hadgkiss,Emily J, AU - Jelinek,George A, Y1 - 2018/05/23/ PY - 2017/08/30/received PY - 2018/05/08/accepted PY - 2018/5/24/entrez PY - 2018/5/24/pubmed PY - 2018/11/27/medline SP - e0197759 EP - e0197759 JF - PloS one JO - PLoS ONE VL - 13 IS - 5 N2 - BACKGROUND: Modifiable risk factors such as smoking and sedentary lifestyle adversely affect multiple sclerosis (MS) progression. Few multimodal behavioural interventions have been conducted for people with MS, and follow-up beyond 1 year is rare for lifestyle interventions. This study assessed adoption and adherence to healthy lifestyle behaviours and health outcomes 3 years after a lifestyle modification intervention, using generalized estimating equation models to account for within-participant correlation over time. METHODS: 95 people with MS completed baseline surveys before participating in 5-day MS lifestyle risk-factor modification workshops. 76 and 78 participants completed the 1-year and 3-year follow-up surveys respectively. Mean age at 3-year follow-up was 47 years, 72% were female, most (62.8%) had MS for 5 years or less, and 73% had relapsing remitting MS (RRMS). RESULTS: Compared to baseline, participants reported clinically meaningful increases in physical (mean difference (MD): 8.0, 95% Confidence Interval (CI): 5.2-10.8) and mental health (MD: 9.2, CI: 5.8-12.6) quality of life (QOL) at 1-year, and physical (MD: 8.7, CI: 5.3-12.2) and mental health (MD: 8.0, CI: 4.2-11.8) QOL at 3-year follow-up. There was a small decrease in disability from baseline to 1-year follow-up (MD: 0.9, CI: 0.9,1.0) and to 3-year follow-up (MD: 1.0, CI: 0.9,1.0), which was not clinically meaningful. Of those with RRMS, compared to baseline, fewer had a relapse during the year before 1-year follow-up (OR: 0.1, CI 0.0-0.2) and 3-year follow-up (OR: 0.15, CI 0.06-0.33). Participants' healthy diet score, the proportion meditating ≥1 hours a week, supplementing with ≥ 5000IU vitamin D daily, and supplementing with omega-3 flaxseed oil increased at 1-year follow-up and was sustained, although slightly lower at 3-year follow-up. However, there was no evidence for a change in physical activity and not enough smokers to make meaningful comparisons. Medication use increased at 1-year follow-up and at 3-year follow-up. CONCLUSION: The results provide evidence that lifestyle risk factor modification is feasible and sustainable over time, in a small self-selected and motivated sample of people with MS. Furthermore, participation in a lifestyle intervention is not associated with a decrease in MS medication use. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/29791509/Health_outcomes_and_adherence_to_a_healthy_lifestyle_after_a_multimodal_intervention_in_people_with_multiple_sclerosis:_Three_year_follow_up_ L2 - http://dx.plos.org/10.1371/journal.pone.0197759 DB - PRIME DP - Unbound Medicine ER -