The NEuRoMS (Neuropsychological Evaluation and Rehabilitation in Multiple Sclerosis) project aims to:
- Develop and evaluate a neuropsychological evaluation pathway, to routinely assess all people with MS for cognitive problems attending NHS MS clinics.
- Develop and evaluate a brief neuropsychological rehabilitation programme for people with MS with mild or moderate cognitive problems, to reduce impact of cognitive problems on personal, professional, and social lives, and improve quality of life.
- To develop an implementation package to enable swift rollout of the neuropsychological screening and rehabilitation programme, should it be clinically and cost-effective.
Study Design and Methods
NEuRoMS is a multi-year programme of research that develops over three phases with six work-packages (WPs), each embedded with several smaller studies.
Phase 1: Development
WP1: Using qualitative methods, we iteratively developed the cognitive screening technology and brief neuropsychological rehabilitation with people with MS and key health and charity stakeholders. We developed and tested the online cognitive screening. We then refined our programme theory and logic model, and developed intervention and staff training protocols.
WP2: We further refined the screening and intervention pathway, and implemented it in three test sites to assess frequency and degree of cognitive problems in people with MS. Using case studies and an observational study method, we evaluated the potential benefits and harms of screening and the brief neuropsychological rehabilitation programme.
Phase 2: Feasibility Testing
WP3: was a three-site feasibility randomised controlled trial (n=79) assessing feasibility outcomes, and intervention fidelity evaluation, with a nested qualitative study to understand barriers and facilitators to progressing to WP4.
Phase 3: Definitive Trial
WP4: Will be the definitive, pragmatic randomised controlled trial, evaluating the clinical and cost-effectiveness of the brief neuropsychological rehabilitation intervention (compared to a usual care control), in seven NHS MS clinics, randomising ≈500 people with MS with mild or moderate cognitive problems.
WP5: The implementation work-package will span all three phases. We will use the qualitative data collected across all WPs (analysed for implementation-relevant content), with additional interviews with stakeholders to understand the process of implementation to real-world contexts.
WP6: will provide further evidence of validity and collect new normative data for the newly developed screening tools.
Phases 1 and 2 have been successfully completed and we are now at the final phase of the study.
We welcome expressions of interest to collaborate with us on any aspect of this programme of research, and our research team would be delighted to supervise PhD students who wish to pursue academic careers in neuropsychology, neurology, rehabilitation, clinical trials/statistics, health economics, and implementation science.
