Kijlstra, Joyce (2025) The Right Fit: A Systematic Review of Cognitive Rehabilitation Program Duration, Intensity, and Format as Predictors of Therapy Adherence in Multiple Sclerosis. Master thesis, Psychology.
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Abstract
Background: Cognitive rehabilitation may help people with multiple sclerosis (pwMS) manage cognitive difficulties. However, to fully benefit from these programs and reduce healthcare costs, it is essential that pwMS are able to engage with and complete them. This systematic review examines how different characteristics of cognitive rehabilitation programs—duration, intensity, and format—may influence therapy adherence. Methods: A systematic literature search was conducted using the following databases: CINAHL, MEDLINE, PsycINFO, Scopus, and Web of Science. Studies were included if they reported on cognitive rehabilitation in pwMS and provided information on therapy adherence. Only articles published between 2015 and 2024 were considered. Results: A total of 5,919 records were identified through database searching, of which 45 studies met the inclusion criteria and were included in this review. Adherence appeared to be highest in shorter programs (≤2 weeks), with more variation in medium and long-term programs. Programs with shorter session durations and higher session frequencies tended to report higher adherence. Differences in adherence were also found between program formats, with slightly higher rates in online formats. Overall, adherence rates were generally quite high across studies and did not vary drastically. However, inconsistent definitions and measurements of adherence limited comparability between studies. Conclusions: Program characteristics - such as duration, intensity, and format - influence therapy adherence in pwMS. Shorter and online programs generally show higher adherence rates. Notably, many studies reported adherence rates of 100%, which suggests potential publication bias. Several included studies involved participants with individual factors like depressive symptoms or advanced disease stages, which—based on supporting literature—may also affect adherence. These findings highlight the importance of considering both program features and individual patient characteristics to improve therapy adherence, optimize treatment outcomes for people with multiple sclerosis, and reduce societal healthcare costs, benefiting both patients and the healthcare system. Keywords: Cognitive rehabilitation, therapy adherence, multiple sclerosis, intervention design, program characteristics
| Item Type: | Thesis (Master) |
|---|---|
| Supervisor name: | Feen, F.E. van der |
| Degree programme: | Psychology |
| Differentiation route: | Clinical Neuropsychology (CN) [Master Psychology] |
| Date Deposited: | 10 Jul 2025 10:03 |
| Last Modified: | 10 Jul 2025 10:03 |
| URI: | http://gmwpublic.studenttheses.ub.rug.nl/id/eprint/5435 |
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