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Internet-based self-help randomized trial for motor functional neurologic disorder (SHIFT).

Gelauff, JM; Rosmalen, JGM; Carson, A; Dijk, JM; Ekkel, M; Nielsen, G; Stone, J; Tijssen, MAJ (2020) Internet-based self-help randomized trial for motor functional neurologic disorder (SHIFT). Neurology, 95 (13). e1883-e1896. ISSN 1526-632X https://doi.org/10.1212/WNL.0000000000010381
SGUL Authors: Nielsen, Glenn

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Abstract

OBJECTIVE: To determine whether self-rated health of patients with motor functional neurologic disorder (FND) can be improved by unguided Internet-based self-help and education. METHODS: In this nonblinded randomized controlled trial, patients were allocated 1:1 unbiased to an unguided education and self-help website in addition to usual care or usual care only. Patients over 17 years of age with a functional motor symptom that caused distress or disability were included. The primary outcome was self-rated health on the Clinical Global Improvement scale at 3 and 6 months. Secondary outcomes were severity of motor symptoms, other physical and psychiatric symptoms, physical functioning, quality of life, work and social adjustment, illness beliefs, and satisfaction with care. RESULTS: A total of 186 patients were randomized, with a follow-up rate of 87% at 6 months. There was no difference in improvement of self-rated health at 3 months (44% vs 40%, p = 0.899) or 6 months (42% vs 43%, p = 0.435). Secondary outcomes did not differ between groups, with a threshold of p < 0.01. Satisfaction was high, with 86% of patients recommending the website to other patients. CONCLUSION: We found no significant effect of the intervention added to usual care on self-rated health or secondary outcome measures, despite high patient satisfaction with the intervention. These results suggest that online education and nonguided self-help could be valuable additions to stepped care for motor FND, but are not effective treatments as interventions in their own right. CLINICALTRIALSGOV IDENTIFIER: NCT02589886. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with motor FND, online education and self-help intervention does not significantly improve self-rated health.

Item Type: Article
Additional Information: Copyright © 2020 American Academy of Neurology
Keywords: 1103 Clinical Sciences, 1109 Neurosciences, 1702 Cognitive Sciences, Neurology & Neurosurgery
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Neurology
ISSN: 1526-632X
Language: eng
Dates:
DateEvent
29 September 2020Published
20 July 2020Published Online
7 April 2020Accepted
Publisher License: Publisher's own licence
PubMed ID: 32690783
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112178
Publisher's version: https://doi.org/10.1212/WNL.0000000000010381

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