Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effectiveness of a Teleconference Delivered Fatigue Management Program for People With Multiple Sclerosis
Brief Summary: Approximately 60% of individuals with multiple sclerosis (MS) describe fatigue as their most disabling symptom. Energy conservation education involves teaching people with MS different strategies to manage fatigue and reduce its impact on daily life. Despite growing evidence of the effectiveness of face-to-face energy conservation education, not all people with MS are able to access these programs. The purpose of this project is to test the effectiveness and efficacy of a teleconference-delivered energy conservation education program for people with MS. The primary goals of the project are to reduce the impact of fatigue on participants' everyday lives, reduce fatigue severity, and improve quality of life. Secondary goals are to increase self-efficacy for managing fatigue and increase the number of energy conservation strategies used. The study will employ a randomly allocated two group time series design with a wait-list control group, which is one type of randomized control trial. A total of 181 people with MS will be recruited through direct mailing and advertising. The program will be delivered by telephone teleconference by a licensed occupational therapist. Outcome measures will be administered over the telephone by a research assistant before and after the program, at three months and at six months. We hypothesize that: (1) individuals in the immediate intervention group achieve better outcomes than individuals in the wait-list control group; (2) the program leads to significant reductions in fatigue impact and fatigue severity, and improved quality of life; and (3) improvements in the outcomes can be maintained over six months.


Options:
A: Inclusion Criteria:

* Patient will be implanted with a Medtronic Conexus-enabled Cardiac Resynchronization Therapy Defibrillator (CRT-D) or Implantable Cardioverter-Defibrillator (DR-ICD) device.

Exclusion Criteria:

* Patient has permanent rapid beats in the upper chamber of the heart (Atrial Fibrillation) - (constant atrial fibrillation in which pharmacological therapy or cardioversion failed or not attempted).
* Patient plans to be on chronic warfarin therapy post-implant and is no longer receiving therapies to attempt to control the rhythm of the beats in their atrium.
* Patient has a previous ICD, CRT-D, Implantable Pulse Generator (IPG) or Cardiac Resynchronization Therapy Pacemaker (CRT-P).
B: Inclusion Criteria:

* Stable systolic heart failure
* New York Heart Association functional class II-III, with a decreased pump function (left ventricular ejection fraction (LVEF) \<45%)
* Titrated to the most optimal doses of ACE-inhibitor or Angiotensin Receptor Blocker, and beta-blocker
* Receiving stable doses of at least 3 heart failure medications (at multiple times during the day) for 1 month with no plans to add or adjust heart failure medications or titrate further in the immediate future.

Exclusion Criteria:

* Age younger than 50 years
* Diastolic heart failure (intact pump function)
* Myocardial infarction, invasive treatment (percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)), or hospitalization within 1 month prior to inclusion
* Life-threatening comorbid conditions (e.g., cancer)
* Diminished mental capacities (suspected cognitive decline will be confirmed by a mini mental state examination (MMSE))
* History of psychiatric disorders apart from affective disorders (depression and anxiety disorders)
C: Inclusion Criteria:

* Age 21 years or more
* Linked using EMR data to a HealthPartners Medical Group primary care clinic
* Within the 12-month period of time prior to screening have had at least 2 primary care outpatient encounters, in the two most recent of which the blood pressure was above Joint National Committee 7 (JNC7) goal (\<140/90 mmHg or \<130/80 for patients with diabetes or kidney disease).
* Have a measured blood pressure at a research clinic screening visit above the JNC7 goal

Exclusion Criteria:

* Acute coronary syndrome or stroke within the past 3 months
* Class III (marked limitation of physical activity) or IV (symptoms at rest) New York Heart Association heart failure, or known left ventricular ejection fraction (\<30%)
* Severe renal dysfunction, with epidermal growth factor receptor (eGFR) ,30 ml/min/1.73 m2 using the abbreviated Modification of Diet in Renal Disease Study (MDRD) equation
* Known secondary causes of hypertension such as coarctation of the aorta, pheochromocytoma, adrenal cortical hypertension or renal vascular hypertension
* Unwillingness to be followed for a period of 18 months
* Pregnancy or unwillingness to use reliable bith control for females of child-bearing age
* Participation in another clinical trial
* Requires an interpreter to communicate with health care providers
* Dementia, mental illness or any condition that would limit ability to give informed consent
D: Inclusion Criteria:

* a diagnosis of MS
* 18 years of age or older
* functional English literacy (i.e., able to read course materials and carry on telephone conservations in English)
* Fatigue Severity Scale score of 4 or greater
* Residing in the state of Illinois

Exclusion Criteria:

* Short version - Blessed Orientation Memory Concentration Test - outside of normal range

Answer: D