TELESM-edu.Nursing: a Personalised Nursing Intervention for People With Multiple Sclerosis

NCT07640698 | Not Yet Recruiting

• 1 other identifier: TELESM1
• Study Type: interventional
• Target: 110
• Locations: 0 countries
• Sites: N/A

Brief Summary

The primary aim of this study is to evaluate the impact of the telenursing intervention "TELESM-edu.nursing" on people with Multiple Sclerosis (pwMS), specifically focusing on their navigational capacity within the healthcare system (Navigation Health Literacy) and their perceived level of Health Literacy. The study will also assess the effectiveness of the intervention in improving patient satisfaction with current therapy, patients' beliefs and attitudes towards the prescribed therapeutic regimen, satisfaction of informational needs, trust in nurses, and degree of disability. The secondary objective is to evaluate the feasibility and sustainability of a personalised telenursing programme for pwMS. Feasibility will be assessed based on: (I) the ability to recruit and retain participants, measured through adherence rates and dropout rates in the intervention group; (II) participants' acceptability, usability, and satisfaction with the intervention; and (III) healthcare staff satisfaction and perceived usability of the intervention. The main research questions addressed in this study are: Does the "TELESM-edu.nursing" intervention improve patients' Navigation Health Literacy and overall Health Literacy levels? Does the intervention improve patient satisfaction with therapy and fulfilment of informational needs? Does the intervention positively influence patients' beliefs and attitudes towards their treatment? Does the intervention increase trust in nurses? What is the impact of the intervention on patients' level of disability? Is the telenursing programme feasible, acceptable, and sustainable for both patients and healthcare professionals? Both study groups will receive the standard in-person informational and educational programme, as well as routine follow-up visits according to the established care pathway. Participants assigned to the intervention group will additionally receive a personalised educational programme lasting six months. This programme will be delivered monthly by a nurse through educational video pills and nurse-led teleconsultations. Participants will be required to watch the video pills and take part in teleconsultations.

Conditions

Multiple Sclerosis (MS); Telenursing

Keywords

Telenursing; Navigation Health Literacy; Health Literacy; Needs Assessment; Nurses; Therapeutics; Multiple sclerosis; Disability Evaluation

Outcome Measures

Primary Outcomes (8)

• Change in Navigational Health Literacy (Ability to Navigate Health Systems and Services) Assessed by the HLS19-NAV Instrument From Baseline to 6-Month Follow-up

  Navigational Health Literacy will be assessed using the Italian version of the HLS19-NAV Instrument for measuring Navigational Health Literacy. The HLS19-NAV includes 12 items assessing the ability to find, understand, appraise, and apply information needed to navigate health systems and services. Items are rated on a 4-point Likert scale, where 1 = very difficult and 4 = very easy. The total HLS19-NAV score will be calculated as the percentage of positive responses ("easy" or "very easy") among valid responses, provided that at least 80% of items are completed. Scores range from 0 to 100 percentage points, with higher scores indicating better navigational health literacy. Unit of Measure: Percentage points on the HLS19-NAV score, range 0-100.

  Assessed at baseline, 3 months, and at the 6-month final follow-up.

• Change in Health Literacy Level Assessed by the Single-Item Literacy Screener (SILS) From Baseline to 6-Month Follow-up

  Health literacy level will be assessed using the Italian version of the Single-Item Literacy Screener (SILS). The SILS consists of a single item assessing how often an individual requires assistance when reading and understanding health-related information. Responses are rated on a 5-point Likert scale ranging from 1 (never) to 5 (always). Scores range from 1 to 5, with higher scores indicating lower health literacy. Based on established SILS cut-offs, participants will be classified as having low health literacy (SILS score ≥3) or adequate health literacy (SILS score \<3). Unit of Measure: Number or percentage of participants classified as having low or adequate health literacy.

  Assessed at baseline, 3 months, and at the 6-month final follow-up.

• Change in Patient Satisfaction With Current Therapy Assessed by a Single-Item Satisfaction Measure From Baseline to 6-Month Follow-up

  Patient satisfaction with current therapy will be assessed using a single-item measure. Participants will be asked to indicate their level of satisfaction with their current therapy using three response categories: very satisfied, moderately satisfied, or little satisfied. Participants reporting dissatisfaction will also be asked to indicate the main reason(s) for dissatisfaction, including mode or frequency of administration, side effects, or symptom worsening. Unit of Measure: Patient satisfaction category (very satisfied, moderately satisfied, or little satisfied).

  Assessed at baseline and at the 6-month final follow-up.

• Change in Beliefs About the Necessity of Prescribed Medicines Assessed by the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) Necessity Subscale From Baseline to 6-Month Follow-up

  Beliefs about the necessity of prescribed medicines will be assessed using the Necessity subscale of the Italian version of the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific). The Necessity subscale comprises 5 items rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 5 to 25, with higher scores indicating stronger beliefs in the necessity of prescribed medications. Unit of Measure: BMQ-Specific Necessity subscale score (5-25 points).

  Assessed at baseline and at the 6-month final follow-up.

• Change in Concerns About Prescribed Medicines Assessed by the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) Concerns Subscale From Baseline to 6-Month Follow-up

  Concerns about prescribed medicines will be assessed using the Concerns subscale of the Italian version of the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific). The Concerns subscale comprises 5 items rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 5 to 25, with higher scores indicating greater concerns regarding the potential adverse consequences of prescribed medications. Unit of Measure: BMQ-Specific Concerns subscale score (5-25 points).

  Assessed at baseline and at the 6-month final follow-up.

• Change in Trust in Nurses Assessed by the Trust in Nurses Scale (TNS) From Baseline to 6-Month Follow-up

  Trust in nurses will be assessed using the Italian version of the 5-item Trust in Nurses Scale (TNS). The scale includes 5 items describing nurses' activities and patients' feelings regarding nursing care. Responses are rated on a 6-point Likert scale ranging from 1 (never) to 6 (always). The total TNS score is calculated by summing the scores of the five items, resulting in a score ranging from 5 to 30. Higher scores indicate greater trust in nurses. Unit of Measure: Trust in Nurses Scale (TNS) total score (range 5-30).

  Assessed at baseline, 3 months, and at the 6-month final follow-up.

• Satisfaction of Patients' Informational Needs at 6-Month Follow-up

  Satisfaction of patients' informational needs will be assessed through analysis of the computerized database used by the nurse to document informational needs expressed during teleconsultation sessions and those subsequently addressed. The analysis will be integrated with qualitative data obtained from audio-recorded teleconsultation transcripts. Informational needs will be classified as met when the nurse provided information or clarification during the teleconsultation and the patient confirmed understanding or resolution of the expressed informational need. Unit of Measure: Percentage of informational needs classified as met.

  Assessed at the 6-month final follow-up.

• Change in Disability Level Assessed by the Expanded Disability Status Scale (EDSS) From Baseline to 6-Month Follow-up

  Disability level will be assessed by a neurologist using the Expanded Disability Status Scale (EDSS). The EDSS evaluates neurological impairment and disability in people with multiple sclerosis. Scores range from 0 to 10, with higher scores indicating greater disability. Unit of Measure: EDSS score (range 0-10).

  Assessed at baseline and at the 6-month final follow-up.

Secondary Outcomes (6)

• Feasibility of the TELESM-edu.nursing Programme Assessed by Participant Retention and Adherence Rates Over the 6-Month Study Period

  Assessed at 3 months and at the 6-month final follow-up.

• Acceptability of the TELESM-edu.nursing Intervention Assessed by a TFA-Based Questionnaire at 6-Month Follow-up

  Assessed at the 6-month final follow-up.

• Usability of the TELESM-edu.nursing Intervention Assessed by a Single-Item Measure at 6-Month Follow-up

  Assessed at the 6-month final follow-up.

• Satisfaction With the TELESM-edu.nursing Intervention Assessed by a Single-Item Measure at 6-Month Follow-up

  Assessed at the 6-month final follow-up.

• Staff Satisfaction With the TELESM-edu.nursing Intervention Assessed Through Semi-Structured Interviews at 6-Month Follow-up

  Assessed at the 6-month final follow-up.

Study Arms (2)

Telenursing Education Program with Video Pills and Teleconsultations

EXPERIMENTAL

Participants assigned to the intervention group will receive, in addition to standard care, a personalised six-month telenursing educational programme including video pills and nurse-led teleconsultations. Six video pills (5-8 minutes) will be sent monthly via email before each teleconsultation and will cover key aspects of multiple sclerosis management. Materials will be developed using Patient and Public Involvement principles with a multidisciplinary team and patient representatives. The programme includes six monthly teleconsultations via a telemedicine platform to assess understanding, support symptom and disability management, identify informational needs, and promote adherence (20-30 minutes each). Prior to the intervention, participants will receive telephone support to access the platform. Teleconsultations will be tailored to health literacy levels using appropriate communication strategies.

Other: TELESM-edu.nursing

Standard Patient Education Program

ACTIVE COMPARATOR

The standard programme involves physicians and healthcare professionals, particularly nurses, providing patients with information about the disease, care pathway, and clinical management. It also includes guidance on selecting reliable information sources and addressing patients' questions and informational needs throughout the care process.

Other: Standard

Interventions

TELESM-edu.nursing OTHER

The teleconsultation intervention will be tailored according to participants' health literacy (HL) levels, adapting content complexity, information load, language, interaction style, and methods to verify understanding, while maintaining consistent participation goals. For patients with low HL, the intervention will focus on simplifying and progressively structuring information, prioritising essential and practical content. Understanding will be assessed using teach-back and Teach-to-Goal strategies. Nurses will provide supportive materials, including brochures with images, diagrams, and key messages, sent via email after each session. For patients with adequate HL, the intervention will include more in-depth content and encourage critical discussion. Additional educational materials and reliable online resources will be provided after teleconsultations to support further learning.

Telenursing Education Program with Video Pills and Teleconsultations

Standard OTHER

The standard informational and educational programme provides that the physician and the health professionals involved in the care pathway, in particular the nurse, furnish patients taken care of at the Centre with information regarding the disease, the therapeutic and care pathway, and the management of the clinical condition. The standard intervention includes education on informed selection of information sources relevant to patients' areas of interest, and the clarification of any questions or informational requests that arise during the care pathway.

Standard Patient Education Program

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients of both sexes (male and female)
• Age 18 years or older
• Confirmed diagnosis of relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), or secondary progressive multiple sclerosis (SPMS)
• Currently receiving pharmacological treatment for multiple sclerosis
• Expanded Disability Status Scale (EDSS) score of 7.5 or lower
• Ability to read and understand Italian
• Ability to provide written informed consent
• Access to a suitable device (smartphone, tablet, or computer with a webcam)
• Access to a home internet connection

You may not qualify if:

• Age younger than 18 years
• Expanded Disability Status Scale (EDSS) score higher than 7.5
• Presence of psychiatric disorders that may interfere with participation in the study
• Presence of cognitive impairment that may interfere with participation in the study

Sponsors & Collaborators

• G. d'Annunzio University: lead

MeSH Terms

Conditions

Multiple Sclerosis

Condition Hierarchy (Ancestors)

Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Nervous System Diseases; Demyelinating Diseases; Autoimmune Diseases; Immune System Diseases

Central Study Contacts

Valentina Simonetti, Associate Professor

CONTACT

+39 (0871) 541205; v.simonetti@unich.it

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: May 25, 2026
• First Posted: June 11, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): June 1, 2027
• Last Updated: June 11, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share