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206 Process evaluation of an interactive web-based relapse management program for people with multiple sclerosis (power@ms2) – mixed-methods-study
  1. Lea Bremer1,
  2. Julia Peper2,
  3. Lisa Wenzel3,
  4. Jutta Scheiderbauer4,
  5. Markus Van De Loo5,
  6. Christoph Heesen3,7,
  7. Sascha Köpke1,
  8. Anne C Rahn2
  1. 1Institute of Nursing Science, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne, Germany
  2. 2Institute of Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
  3. 3Institute for Neuroimmunology and Multiple Sclerosis, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
  4. 4Stiftung für Selbstbestimmung und Selbstvertretung von MS-Betroffenen, Trier, Germany
  5. 5Deutsche Multiple Sklerose Selbsthilfe Gesellschaft, Bundesverband, Hannover, Germany


Introduction Relapsing-remitting multiple sclerosis (MS) is characterized by relapses of new or worsening neurological symptoms and periods of recovery. We developed a web-based program (POWER@MS2) to support people with MS (PwMS) in decision-making regarding relapse management. The program consists of three components (dialogue-based decision aid (DA), nurse- led webinar, online chat). POWER@MS2 was evaluated in a randomized controlled trial (RCT) accompanied by a process evaluation (PE), aiming to identify implementation barriers and facilitators and to understand change mechanisms.

Methods The mixed-methods PE is based on the MRC complex interventions framework. PwMS and experts (neurologists, study nurses) participated in the study. During the RCT, participants received questionnaires about the intervention and study organization. Based on the results, semi-structured interview guides were developed. Expert interviews were recorded and transcribed. Currently, we are analyzing the expert interviews thematically and recruiting PwMS for the interviews. We will use joint displays to merge quantitative and qualitative findings.

Results Quantitative data are available from n=72 experts and n=159 PwMS (intervention n=79, control n=80). After six months 90% of n=38 neurologists stated that PwMS participated more actively in relapse management. We interviewed 11 experts, who stated that the program promotes shared decision- making in relapse management. In the intervention group, the program was used by 98% of participants. After three months, 97% stated to like the dialogue-based approach of the DA. 34 PwMS in the intervention group had one or more relapses during the observation period. Of these, 71% (n=24) used the DA for acute relapses and all found it helpful.

Discussion The interviews with PwMS will address selected aspects based on quantitative study results and characteristics of participants, aiming to optimize the intervention and to further explore study findings.

Conclusion Decision aids with a dialogue-based approach are suitable to support PwMS in making decisions regarding relapse management.

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