Objective: To determine whether there were any differences in the outcomes of individuals with multiple sclerosis who attended all six sessions of an energy conservation education programme compared with people who missed a session and received a self-study module. Design: Secondary analysis of data from two naturally occurring groups emerging from a randomized control trial - compliers who received the intervention as intended (group 1) and noncompliers who received a modified intervention with self-study modules (group 2). Setting: Community settings in Chicago, Illinois and Minneapolis, Minnesota, USA. Participants: Ninety-two community-dwelling people with multiple sclerosis who were participating in an energy conservation education programme. Intervention: Energy conservation education groups based on the 'Managing Fatigue' programme, which were facilitated by an occupational therapist. Self-study modules were sent to participants who missed a session. Outcome measures: Fatigue Impact Scale (FIS), Self-Efficacy for Performing Energy Conservation Strategies Assessment, Energy Conservation Strategies Survey (ECSS), six subscales from the Medical Outcomes Study Short-Form Health Survey (SF-36). Results: When comparing individuals who attended all six sessions with individuals who missed one or more sessions and received a self-study module, no significant differences were found after adjusting for multiple comparisons. Conclusion: Participants who used the self-study modules because they missed sessions of the Managing Fatigue programme experienced benefits from the course similar to those experienced by participants who fully complied with the intervention as intended. A new prospective study to validate the findings of this secondary analysis is required.
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