Sweetland, J.C.; (2012) Vocational rehabilitation for people with multiple sclerosis. Doctoral thesis , UCL (University College London).

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Abstract

The aim of this research was: to explore the published literature and the experiences of people working with multiple sclerosis (MS); to use information collected to develop and trial a vocational rehabilitation (VR) service; to evaluate the cost utility and impact on service users; and to implement a randomised control trial (RCT). The Medical Research Council’s framework ‘Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Health’ was used to structure the study and facilitated the use of mixed methodologies. These included focus groups, patient reported outcome measures, semi-structured interviews and an RCT. Barriers to working with MS were identified in the literature and in the focus group discussions. Focus group participants helped design the VR service. This service cost a mean of £730 to provide and appeared effective in maintaining participants in their working roles. The need for early intervention was described at all stages of this study and formed the basis for the VR service trialled in the RCT. The RCT has a five year follow up period and therefore only preliminary results are reported here. This study demonstrates how service users can be usefully engaged in the development of a service. The results define the VR intervention offered and analysis shows the service was relatively inexpensive to provide. Although only small numbers were recruited at each stage of the study the results still add to the growing evidence for the provision of VR for people with long term neurological conditions.

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