Investigating Self-Management and Disease Outcomes over time in Patients with Persistent Symptoms of Lyme Disease Syndrome: A Secondary Analysis of Longitudinal Data

This study investigated the relationship between self-management and a group of disease outcomes over time, namely working ability (number of paid working hours), mental health (anxiety and depression) and symptom severity (pain and fatigue), in participants with Post-Treatment Lyme Disease Syndrome (PTLDS). PTLDS is a condition where a patient experiences symptoms for six months or longer after being treated for acute Lyme disease. Symptoms include fatigue, pain and cognitive impairment and can be very burdensome to these patients. Currently, there is no official treatment and very little information on how the illness interacts with common interventions. This study used data collected in the PLEASE (Berende et al., 2014) and PLEASE 5+ (Kullberg et al., 2020) studies. These studies gave surveys to the same participant pool (n = 201) once during a placebo-controlled randomised clinical trial of long-term antibiotics treatment (PLEASE) and a follow-up assessment 7 years later (PLEASE...Show moreThis study investigated the relationship between self-management and a group of disease outcomes over time, namely working ability (number of paid working hours), mental health (anxiety and depression) and symptom severity (pain and fatigue), in participants with Post-Treatment Lyme Disease Syndrome (PTLDS). PTLDS is a condition where a patient experiences symptoms for six months or longer after being treated for acute Lyme disease. Symptoms include fatigue, pain and cognitive impairment and can be very burdensome to these patients. Currently, there is no official treatment and very little information on how the illness interacts with common interventions. This study used data collected in the PLEASE (Berende et al., 2014) and PLEASE 5+ (Kullberg et al., 2020) studies. These studies gave surveys to the same participant pool (n = 201) once during a placebo-controlled randomised clinical trial of long-term antibiotics treatment (PLEASE) and a follow-up assessment 7 years later (PLEASE 5+). The average age of this cohort is 58 and there was an approximately equal spread of males and females. Participants had been PTLDS patients for five years on average. Statistical analyses were performed on this data using hierarchical regression and Pearson correlation analyses. Higher self-management at baseline was associated with lower fatigue severity 7 years later (controlled for baseline fatigue) (p = .019). No significant relationships were found between self-management and the other disease outcomes tested. This result implies that higher self-management skills can positively affect fatigue severity over time in PTLDS patients, however, the relationships between self-management and workability, mental health and pain are more complicated. This information can be used to form a basis to do experimental research into the efficacy of self-management interventions for fatigue in this group. In post-hoc analyses, self-management was found to correlate with these variables at the second measurement, meaning that higher self-management tended to coincide with better workability, mental health and pain outcomes. One major limiting factor for this study was the measurement of self-management. This study used a survey that measured self-efficacy surrounding self-management, but this leaves room for bias, specifically for the Dunning-Kruger effect. This is the bias where individuals with lower skill levels tend to rate their skills higher than people with higher skill levels.Show less

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Investigating Self-Management and Disease Outcomes over time in Patients with Persistent Symptoms of Lyme Disease Syndrome: A Secondary Analysis of Longitudinal Data