The effect of spaced presentation of treatment information on recall and understanding of risk relating to medication in Multiple Sclerosis

Michele Burns

Research output: ThesisDoctoral Thesis

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Recent developments of more effective Multiple Sclerosis (MS) medications with severe side-effect profiles mean that patients with MS must recall and comprehend highly complex risk-benefit treatment information. Yet studies have shown reduced risk awareness in people with MS, which may be associated with MS-related cognitive impairments (e.g. reduced information-processing speed and learning). Spaced presentation, whereby information is presented over time and interspersed with breaks, can improve recall in patients with MS on simple paragraph and name-learning tasks. However the benefits of spaced presentation in patients with MS have not been explored for more complex, clinically-relevant information. The present study explored whether spaced presentation of treatment-related risk information leads to improved recall and understanding in patients with MS (n=30) and healthy controls (n=30). Participants heard information about fictitious drugs presented in three formats: with gaps (spaced condition), continuously (massed condition), and continuously followed by a 10-minute delay (massed-with-delay condition). Immediate recall and understanding was assessed. They also completed neuropsychological tests. Mixed design ANOVAs showed a main effect of group, with MS participants performing significantly worse than controls for both immediate recall and understanding of treatment-related risk information. There was also a main effect of presentation format for immediate recall. Participants recalled significantly more information in the spaced relative to both massed and massed-with-delay conditions and in the massed relative to the massed-with-delay condition. Cognitive deficits correlated with recall and comprehension in the MS group. This study provides initial support for the benefit of spacing for recall of risk information in MS. However, spaced presentation did not aid comprehension of treatment-related risk information in either group. The breaks in information presentation may ameliorate effects of reduced processing speed on recall. However, the complexity of comprehending medication risk information may be too great a challenge for a spacing intervention to overcome in the context of MS-related cognitive impairment. Clinical implications are discussed.
Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
  • Langdon, Dawn, Supervisor
Award date1 Nov 2015
Publication statusUnpublished - 2015


  • Michele Burns
  • Multiple Sclerosis
  • Spaced presentation
  • risk awareness

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