Access, Use and Opinions of Physiotherapy and Rehabilitation Services of People With Progressive MS in the UK.

Progressive Multiple Sclerosis Clinical Trial

Official title:

Current Access to, Use and Perceived Efficacy of Physiotherapy and Rehabilitation Services by People With Progressive Multiple Sclerosis: a Survey of People With Progressive Multiple Sclerosis Via the UK MS Register.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02559765
• Other study ID #: 200140102
• Status: Completed
• Phase: N/A
• First received: September 21, 2015
• Last updated: May 11, 2016
• Start date: August 2015
• Est. completion date: November 2015

Study information

• Verified date: May 2016
• Source: University of Glasgow
• Contact: n/a
• Is FDA regulated: No
• Health authority: United Kingdom: National Health Service
• Study type: Observational

Clinical Trial Summary

This survey will investigate the views of people with progressive MS in terms of physiotherapy services. In particular the study will examine the proportion of people with progressive MS on the MS register who use physiotherapy services, how worthwhile they think it is for them and how they would like their physiotherapy to be delivered. This survey will also explore how physiotherapy services for people with progressive MS varies across the UK and what other types of rehabilitation services are currently used by people with progressive MS.

Description:

Multiple Sclerosis has three main forms: Relapsing Remitting MS (RRMS), Primary Progressive MS (PPMS) and Secondary Progressive MS (SPMS) as well as a rarer form called Progressive Relapsing MS (PRMS).

In cases of RRMS an individual will have periods of worsened symptoms followed by periods of remission. During remission the individual may make a full recovery or be left with some residual impairment. In both PPMS and SPMS an individual will have continuous worsening symptoms with a gradual increase in disability with little or no transient recovery. An individual with PRMS will have the continuous worsening of disability seen in both PPMS and SPMS coupled with occasional relapses as seen in RRMS.

Currently 15% of those with MS are diagnosed as PPMS, 5% are diagnosed with the rarer form of PRMS and approximately 80% are diagnosed with RRMS. However, approximately 65% of those with RRMS will go on to develop SPMS. This means that approximately 72% of all individuals with MS will be in a progressive phase of the disease at some point in their life.

Whilst there are disease modifying drugs available for those with RRMS there are currently limited pharmacological treatments available for those with the progressive forms of the disease. Physiotherapy and rehabilitation services are often used by people with progressive MS and access to these are part of the current NICE guidelines for the management of MS. Whilst physiotherapy and rehabilitation services are used by people with progressive MS there is currently no research investigating how many people with progressive MS use these services, who provides them, how they are delivered, how effective the recipient feels the treatment is and how they would like their service to be delivered. In addition the Progressive MS Alliance has highlighted progressive MS and symptom management and rehabilitation as an under-researched area.

The UK MS Register is funded by the MS Society and operated by the health informatics department within the College of Medicine at Swansea University. People with MS can sign up to the register and answer pre-set questionnaires online. The purpose of the Register is to be a longitudinal research database collecting routine data every three months as well as conducting individually commissioned cross sectional studies. It currently has over 11,000 members and over 2,200 of those registrants have a progressive form of MS. Not only is this is the first study with the UK MS register to focus on people with progressive forms of MS but also the first to focus on physiotherapy services.

This is a unique opportunity to access this patient group across a large geographical region and gain an insight into how physiotherapy and rehabilitation services are used, delivered and perceived. The outcome of this research has the potential to inform future physiotherapy interventions and rehabilitation guidelines.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1298
• Est. completion date: November 2015
• Est. primary completion date: November 2015
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Have a form of progressive MS

• Be registered on the UK MS Register

Exclusion Criteria:

• Have relapsing remitting MS

• Be under 18 years of age

Study Design

Observational Model: Cohort, Time Perspective: Cross-Sectional

Related Conditions & MeSH terms

• Multiple Sclerosis
• Progressive Multiple Sclerosis
• Sclerosis

Locations

Country	Name	City	State
United Kingdom	The University of Glasgow	Glasgow

Sponsors (3)

Lead Sponsor	Collaborator
University of Glasgow	AKM Stats, NHS Ayrshire & Arran

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of participants with access to physiotherapy for their MS. Questionnaire	Questionnaire has the following options: yes, no. Participant may choose one.	three months	No
Primary	Number of participants that use physiotherapy for their MS. Questionnaire	Questionnaire has the following options: yes, no. Participant may choose one.	three months	No
Primary	What is the participants' perceived efficacy of physiotherapy for their MS? Questionnaire	Nominal scale of: very harmful, harmful, neither harmful nor beneficial, beneficial, very beneficial Participant may choose one.	three months	No
Secondary	Most common referral process. Questionnaire	Participant may choose from the following options and choose more than one: Neurologist; GP; self-referral; MS nurse; other (please state); don't know	three months	No
Secondary	Most common provider of physiotherapy to the participant. Questionnaire	Participant may choose from the following options and choose more than one: NHS; private (self funded); private (insurance); charity; other (please state)	three months	No
Secondary	Most common physiotherapy intervention received for participant's MS. Questionnaire	Participant may choose form the following options and choose more than one: exercises to do at home prescribed by a physiotherapist; exercises with a physiotherapist; functional electrical stimulation, transcutaneous electrical stimulation; tilt table; acupuncture; advice or education from a physiotherapist; other (please state)	three months	No
Secondary	Most common pattern of physiotherapy appointments. Questionnaire	Participant may choose from the following options and choose only one: receiving physiotherapy sessions regularly; pattern varies depending on symptoms.	three months	No
Secondary	Most common expected waiting time from referral to receiving physiotherapy appointment. Questionnaire	Participant may choose form the following options and choose only one: less than a week; 1 to 2 weeks; 2 or more weeks but less than 4 weeks; 4 or more weeks but less than 6 weeks; 6 or more weeks but less than 12 weeks; 12 or more weeks.	three months	No
Secondary	Most common frequency of appointments. Questionnaire	Participant may choose form the following options and choose only one: once or more a week; once a fortnight; once every 1 to 3 months; twice a year; once a year or less	three months	No
Secondary	Most common length of physiotherapy sessions. Questionnaire	Participant may choose form the following options and choose only one: up to half an hour; between half an hour and an hour; more than an hour.	three months	No
Secondary	Most common number of people present at physiotherapy sessions. Questionnaire.	Participant may choose form the following options and choose more than one: one to one; 2- 4 people, 5 or more people; over the phone or internet.	three months	No
Secondary	Most common setting of receipt of physiotherapy. Questionnaire	Participant may choose form the following options and choose more than one: at home; in a hospital or clinic; in a community centre; in a charity centre; other (please state)	three months	No
Secondary	Number of participants who think they need more physiotherapy than they currently receive. Questionnaire	Participant may choose form the following options and choose only one: yes; no; don't know	three months	No
Secondary	Most common desired pattern of delivery of physiotherapy. Questionnaire	Participant may choose form the following options and choose only one: regularly; to vary depending on symptoms.	three months	No
Secondary	Most common desired frequency of appointments. Questionnaire	Participant may choose form the following options and choose only one: once or more a week; once a fortnight; once every 1 to 3 months; twice a year; once a year or less	three months	No
Secondary	Most common desired length of physiotherapy appointments. Questionnaire	Participant may choose form the following options and choose one: up to half an hour; between half an hour and an hour; more than an hour.	three months	No
Secondary	Most common desired setting for receiving physiotherapy. Questionnaire	Participant may choose form the following options and choose one: at home; in a hospital or clinic; in a community centre; in a charity centre; other (please state)	three months	No
Secondary	Most common desired number of people present at physiotherapy sessions. Questionnaire.	Participant may choose form the following options and choose one: one to one; 2- 4 people, 5 or more people; over the phone or internet.	three months	No
Secondary	Most common barriers to receiving physiotherapy. Questionnaire.	Participant may choose form the following options and choose more than one then rate their most severe from 1-3: Pain; fear of falling; bladder or bowels problems; fatigue; depression; anxiety/panic attacks; difficulty with walking; difficulty with wheelchair transfers; transport problems; distance to travel; lack of suitable parking; lack of time; family commitments; work commitments; cost; need someone to come with me; personal issues with physiotherapist; problems being referred to physiotherapy; physiotherapy is not available; physiotherapy will not be beneficial for me; there is nothing that makes it difficult for me to receive physiotherapy; other (please state)	three months	No
Secondary	Number of participants who have access to MS specialist services. Questionnaire	Participant may choose from the following options and choose one: yes; no.	three months	No
Secondary	Number of participants who are able to access MS specialist services as their needs change. Questionnaire	Participant may choose from the following options and choose one: yes; no.	three months	No
Secondary	Most common health professional available as part of MS specialist services. Questionnaire	Participant may choose from the following options and choose more than one: Occupational therapist; Social worker; MS specialist nurse; Continence nurse; Nurse: other (please state); Psychologist; GP; MS specialist Doctor/Neurologist; Doctor: other (please state); Speech and language therapist; Dietician; Orthotist; Other (please state)	three months	No
Secondary	Most commonly used health professional available as part of MS specialist services. Questionnaire	Participant may choose from the following options and choose more than one: Occupational therapist; Social worker; MS specialist nurse; Continence nurse; Nurse: other (please state); Psychologist; GP; MS specialist Doctor/Neurologist; Doctor: other (please state); Speech and language therapist; Dietician; Orthotist; Other (please state)	three months	No
Secondary	Number of participants who are offered a regular review for their MS. Questionnaire	Participant may choose from the following options and choose one: yes; no; don't know	three months	No
Secondary	Most common frequency of review. Questionnaire	Participant may choose from the following options and choose one: twice a year; once a year; less than once a year; don't know.	three months	No
Secondary	Most common health professional who carries out review. Questionnaire	Participant may choose from the following options and choose one: MS specialist Doctor/Neurologist; GP; Nurse; Physiotherapist; Occupational therapist; The person who does my review can vary; Other (please state)	three months	No
Secondary	Most common setting of review. Questionnaire	Participant may choose from the following options and choose one: at home; in a hospital or clinic; in a community centre; GP surgery; other (please state)	three months	No
Secondary	Most common disease modifying therapy taken in past. Questionnaire	Participant may choose from the following options and choose one: Beta-interferon (Rebif, Avonex, Betaferon); Glatiramer acetate (Copaxone); Dimethyl fumarate (Tecfidera); Teriflunomide (Aubagio); Natalizumab (Tysabri, Antigren); Fingolimod (Gilenya, Novartis); Mitoxantrone (novantrone); Alemtuzumab (Lemtrada); I have never taken any of these medications	three months	No
Secondary	Most common disease modifying therapy being taken. Questionnaire	Participant may choose from the following options and choose one: Beta-interferon (Rebif, Avonex, Betaferon); Glatiramer acetate (Copaxone); Dimethyl fumarate (Tecfidera); Teriflunomide (Aubagio); Natalizumab (Tysabri, Antigren); Fingolimod (Gilenya, Novartis); Mitoxantrone (novantrone); Alemtuzumab (Lemtrada); • I do not currently take any of these medications	three months	No
Secondary	Most commonly used complimentary therapy used for MS. Questionnaire	Participant may choose from the following options and choose more than one: Massage; Reflexology; Osteopathy or chiropractic; Magnet field therapy; The Alexander technique; Acupuncture or acupressure; Hyperbaric oxygen therapy; Reiki; Aromatherapy Relaxation or meditation; Homeopathy or herbal medicine; Other (please state)	three months	No