Evaluation of the impact of 4 booster sessions on the fatigue scores after the application of a cognitive-behavioral fatigue management program in patients with relapsing-remitting multiple sclerosis: randomized controlled trial ; Evaluation de l’impact de 4 séances de rappel sur le maintien des scores de fatigue après l’application d’un programme cognitivo-comportemental de gestion de la fatigue chez des patients atteints de sclérose en plaques récurrente-rémittente : essai contrôlé randomisé

Background : Fatigue is an invisible symptom of multiple sclerosis (MS) that is highly disabling and interferes with patients' daily life. The lack of effectiveness of available drug treatments and the entanglement of this fatigue with psychological factors have led to the development of fatigue management programs, most based on the principle of Cognitive Behavioral Therapies (CBT). The effectiveness of these interventions, assessed from Randomized Controlled Trials (RCTs), has been demonstrated in the treatment of MS-related fatigue, but their effects are not sustained in the long term (beyond 6 months).Objective : The objective of this study is to assess the maintenance at 12 months of a 6-week CBT program supplemented by 4 booster sessions, compared to standard care, on the severity and impact of fatigue in 105 patients with relapsing-remitting MS and suffering from fatigue. Method : This is randomized controlled trial versus standard care and multi-center. This RCT consists of the addition of 4 booster sessions to the initial FACETS program designed by Thomas et al (2013). 105 patients, recruited from CHI Poissy-Saint-Germain-en-Laye, Raymond Poincaré Hospital in Garches, and Centre Hospitalier de Gonesse, were randomly assigned either the FACETS + experimental group (initial FACETS program and 4 booster sessions) or to the control group consisting of standard care. The randomized groups showed homogeneous characteristics. The main criterion is the evolution of the fatigue score assessed by the Modified Impact Scale (MFIS) between M0 and M12.Results : At 12 months, the adjusted mean of the MFIS was 41.2 ± 15.73 in the FACETS group, and 50.23 ± 13.39 in the control group (p<0.01) and tends to remain at 18 months. This result is found on the secondary criteria (FSS, MSIS PHY).Discussion : This RCT confirms the effectiveness of programs based on CBT principles in the treatment of MS-related fatigue. However, it is the first to use booster sessions and achieve a maintenance of therapeutic benefits at 12 ...