A growing body of evidence suggests that integrative medicine (IM) modalities can enhance the comprehensive care of patients with multiple sclerosis (MS). Thirty to eighty percent of patients with MS already use complementary and alternative approaches (e.g., yoga, mindfulness/meditation, and dietary changes). Unfortunately, medical insurance does not usually cover IM modalities, and their benefits may be under-accessed because of the expense.

In her presentation at the ECTRIMS 2021 meeting, Dr. Megan Weigel (First Coast Integrative Medicine, Jacksonville, Florida) presented her research on a virtual IM program to help people with MS.

An opportunity to evaluate an IM program

The COVID-19 pandemic provided Dr. Weigel, an Advanced Practice Registered Nurse, and her colleagues (Dr. Linda Connelly and Mehgan Fox) with an opportunity to evaluate the organization, management, and implementation of a virtual IM program which they called “Inspire My Soul” (“Inspire MS”). Inspire MS was designed to improve quality of life (QoL), self-efficacy, and wellness in MS. In a 6-week-long series of virtual, expert-guided weekly workshops, the topics covered included integrative medicine, journaling, meditation, nutrition/cooking, yoga therapeutics, art instruction, sound healing, music therapy, pelvic floor and balance therapy, health coaching, and soul therapy.

Benefits of the Inspire MS program and “missing pieces”

Of 21 people who registered, 15 completed the program (mostly female, over 51 years of age, living with MS for > 11 years and taking a disease-modifying therapy). Benefits of participating in the program reported by patients included “gaining a new perspective,” “improved mood,” as well as practical benefits (e.g. recognition of “personal responsibility to change habits” or “the need to take time for myself”). The areas of improvement, or “missing pieces”, mentioned by patients included reinforcing benefits through support between sessions and better technical support for the digital platform.

Assessments based on the MSSE Scale, MS Wellness questionnaire and SF-36 questionnaire

Participants completed the MS Self-Efficacy (MSSE) Scale, the MS Wellness questionnaire, and the 36-item Short Form Survey (SF-36) at Weeks 1 and 6 of the study. The MSSE Scale assesses function and control (higher scores indicate better adjustment and may also reflect treatment adherence). In contrast to evaluations and open-ended questions, which supported the benefits of the program, the MSSE Scale assessments revealed a small negative impact for the control measure and no/negligible impact on the function measure. The MS Wellness questionnaire also showed no impact on wellness. The SF-36 questionnaire, however, indicated a shift to positive scores (based on comparisons of means; not statistically analyzed).

Among the factors that might have influenced the results of the MSSE Scale/MS Wellness questionnaire, Dr. Weigel mentioned the short duration of the study (e.g. not enough time to adopt IM modalities into daily life), as well as the possibility of a “response shift phenomenon” (where changes in health status cause shifts in how patients evaluate aspects of their health).¹ Other limitations included a small sample size and no control group. Dr. Weigel also mentioned the potential loss of a “personal connection” with the digital platforms as a limitation.

Areas for future investigation and conclusion

Dr. Weigel stated that future programs should include “check-ins” between workshop sessions, longer follow-up, and addition of a qualitative component to help better understand themes associated with QoL from a patient perspective. Response shift also needs to be further defined. Dr. Weigel concluded that IM provides patients with MS with a safe and effective adjunct to conventional medical care of whole-person MS treatment.

For more coverage from ECTRIMS 2021, please click here.

Reference

1. Schwarz CE et al. Psycho-Oncol 1999;8:344–54.