Lifestyle and complementary therapies in multiple sclerosis guidelines: Systematic review

Area of Science:

• Neurology
• Evidence-based Medicine
• Health Management

Background:

• Multiple sclerosis (MS) management involves clinical interventions and self-management strategies.
• Lifestyle modifications (exercise, smoking cessation) and complementary therapies are crucial, particularly with limited healthcare access.
• The extent to which MS guidelines address these strategies remains unclear.

Purpose of the Study:

• To systematically review MS clinical practice guidelines and consensus statements.
• To assess the inclusion and quality of recommendations on lifestyle modifications and complementary therapies.
• To identify gaps in guideline development and applicability for people with MS.

Main Methods:

• Systematic review of multiple databases (MEDLINE, EMBASE, etc.) and guideline repositories.
• Independent screening and data extraction by two researchers.
• Quality assessment using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.

Main Results:

• Thirty-one guidelines and consensus statements were included.
• Overall guideline quality was moderate to high, but 'applicability' was low (29%).
• Only two high-quality guidelines were intended for people with MS, focusing on physical activity, mindfulness, smoking cessation, and supplements.

Conclusions:

• High-quality, applicable guidelines for lifestyle and complementary therapy in MS management are scarce.
• There is a need for more guidelines specifically for people with MS.
• Enhanced implementation resources are required to support the uptake of these strategies.