This research study aims to discover factors that worsen feelings of fatigue in people living with multiple sclerosis (MS). Most research studies explore topics like this using scientific approaches that report the average results of a group of people, rather than the results for an individual.
‘Group-based’ approaches are typically used in MS research and the data collected is assumed to represent all individuals with MS. This emphasis on group-based approaches means there is a lack of knowledge about how and why fatigue symptoms fluctuate from day to day in individuals.
Dr Suzanne McDonald and her co-investigators will use ‘N-of-1’ methods to identify personalised patterns and triggers of fatigue in individuals with MS. N-of-1 studies involve repeated outcome measurements in the same person over time, to draw conclusions specific to that individual.
Dr McDonald will explore personal patterns and triggers of fatigue in a 6-week N-of-1 study, asking people with MS and fatigue a few brief questions about fatigue and triggers on a daily basis.
To explore whether people with MS will be able and willing to participate in N-of-1 research, participants will be interviewed at the end of the study about their views on study design and procedures. If the methods are feasible and acceptable to people with MS, the N-of-1 design can be extended to testing treatments for MS symptoms at the individual patient level, providing personalised results for each patient.
Dr McDonald and her team have made significant progress in evaluating whether N-of-1 studies are a practical and useful approach for studying people with MS and fatigue. They are also exploring whether this personalised approach can help people with MS better understand and manage their fatigue.
Ten people completed the full 6-week study, and seven of them chose to extend their participation for an additional six weeks. Participants consistently completed their daily symptom tracking, providing valuable data on how fatigue changes over time. Participants completed three surveys each day for six weeks (126 surveys in total).
Interviews are ongoing to gather participant feedback and determine feasibility and acceptability of the study methods. This includes information on how easy it was to track their symptoms and whether their personalised results were useful for fatigue management.
Over the next 12 months, Dr McDonald and her team will build on the findings of this project by refining data collection methods, expanding the application to other types of N-of-1 trial designs, and exploring integration into clinical practice. They will enhance symptom tracking tools to improve usability and engagement to ensure personalised feedback is an effective self-management strategy for individuals with MS.
The next phase of this research will focus on testing fatigue management interventions through interventional N-of-1 trials, including aggregated N-of-1 trial designs that provide both individual- and group-level conclusions. Collaborating with health professionals will help develop a framework for incorporating N-of-1 trials into routine care, with training materials to support their adoption.
Dr McDonald is presently preparing a paper for publication based on her research.
Updated 31 March 2025
$25,000
2023
1 year
Current project
