Reviewing the Power of Health and Wellness Coaching in Multiple Sclerosis Care

Cassandra Moore, MPH, CPH

(Credit: LinkedIn)

Health coaching could be an effective patient education method for the management of chronic diseases such as multiple sclerosis (MS). According to a recently published study, findings revealed that health coaching was particularly effective in changing the lifestyle behavior of patients with chronic diseases and in improving their self-efficacy, physical as well as mental health status. These results suggested that health coaching may help clinicians engage patients in behavior change and enhance adherence to self-care routines outside the clinical setting.¹

In another study, findings showed that health and wellness coaching was effective on short-term outcomes of self-efficacy, depression, and quality of life among patients living with chronic illness.² Notably, the prior study reported that health and wellness coaching did not have an impact on patient anxiety at any time point and did not find evidence of long-term benefit. The previous study suggested that it may be useful to investigate the long-term impact of health and wellness coaching on patients with chronic diseases, observing whether the effects persist over a longer period of time or if booster interventions may be required.

Leading expert Cassandra Moore, MPH, CPH, presented on the integration of health and wellness coaching into MS care at the 2025 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 28-31, 2025, in Phoenix, Arizona.³ Following the presentation, Moore, associate vice president of strategy and innovation at the National MS Society, spoke with NeurologyLive^® to further discuss how coaching can improve self-efficacy, physical and mental health, and quality of life in patients with MS. In the conversation, she emphasized that mindset may one of the key determinants for coaching success and explained how coaches can complement multidisciplinary teams in patients’ aspects of their care plans.

NeurologyLive: How have you seen health coaching influence clinical outcomes on patient adherence in MS care?

Cassandra Moore, MPH, CPH: There is a growing body of published research that provides evidence for the positive clinical benefits of health and wellness coaching. I referenced an article during my presentation titled The Impact of Health and Wellness Coaching on Patient-Important Outcomes and Chronic Illness Care: A Systematic Review and Meta-Analysis. This was published in 2023 and analyzed 30 studies published in the last 18 years that compared health and wellness coaching to standard clinical care or another intervention without coaching. They found that health and wellness coaching improved short-term self-efficacy, quality of life, and depression for patients with chronic conditions.

Another study titled The Effects of Health Coaching on Adult Patients With Chronic Diseases: A Systematic Review analyzed 13 studies published from 2009 to 2013, focusing on health coaching for adults with chronic diseases by health care professionals. They found statistically significant results for better weight management, increased physical activity, and improved physical and mental health status.

We implemented 2 cohorts of health and wellness coaching, and in our coaching program, we saw improved physical health for both cohorts and an improvement in mental health for the second cohort. We also saw an increase in self-efficacy for both cohorts. In addition to these more tangible outcomes, feedback that we have received suggests that coaching has had a profound result. One of our coaching participants said that she was on the verge of getting on medication for depression when she started coaching, and then after going through it, she had a completely different mindset. She’s no longer experiencing depression, and she’s feeling happy about the outlook of her life and health.

In what ways can health coaching be integrated into the multidisciplinary MS care teams and what role does it play initially in the treatment plan?

I think a lot of the coaches that we've worked with would love to be a part of the treatment team, and many of them consider themselves a part of the team as well. Coaching and the coach-coachee relationship is different from other relationships. For our program in particular, you spend on average 45 minutes talking with someone each week—you’re going to build a relationship with them. There might be a different layer of depth that comes from time spent together and sharing so many different aspects of your life that you may not get from, say, your neurologist.

I think an ultimate goal is holistic care, and sometimes there is a gap or hole in care teams. Whereas providers usually have one area of focus, coaches can really help patients incorporate and coordinate all aspects of their treatment plan. A patient might discuss their disease-modifying treatment with their neurologist, their mobility with their physical therapist, and their mental state with their psychotherapist. Then a coach can partner with patients and guide them in figuring out how to pull it all together, making goals informed by their treatment plan and discussing progress and setbacks thoughtfully. Health and wellness coaches really support people to achieve their self-directed goals and behavioral changes that are informed by any treatment plans prescribed by the rest of the professional health care team.

What patient characteristics or clinical scenarios could make someone a strong candidate for health coaching in their MS journey?

I don’t really think that there is a specific clinical scenario that would make someone a strong candidate for health coaching. A lot of it is readiness and mindset. In our coaching program, we worked with people who were newly diagnosed—defined as being diagnosed in the past 3 years—and most of those people agreed that it was a really good time for them to engage in coaching. For a lot of them, their lives had recently changed. They had a lot of questions, maybe were feeling uncertainty, so it was nice they had a coach to navigate their new normal.

Alternatively, one of our participants, who was very newly diagnosed, said that although she really enjoyed the program, her diagnosis was still so fresh, and she was still grieving, really—and she probably would have benefited more if she had gone through coaching a year later or so. I also spoke with a participant who shared that he thought coaching was the right time for him, but he was also chatting with his mentor about coaching. She was diagnosed over 20 years ago, and she said that she had been living in a stagnant state, and maybe coaching could be beneficial for her as well to get her moving and setting goals.

We had a pretty diverse demographic pool. We had people who weren’t experiencing disability at all and people who had experienced disability in life-changing ways, some people with progressive MS and some who had been diagnosed with relapsing-remitting. We had a range of races and ethnicities, people from all over the country, and even someone living outside of the country in one of our cohorts. We worked with both men and women, ages ranging from their 20s to late 60s.

We did have to do some general education at the start of the program around what exactly coaching is and what some of the benefits are. But primarily, I just think that people have to be in the place where they’re ready to maybe talk, or ready to make some changes, or ready to embrace health and wellness coaching. I think the mindset is the most important piece.

There are some profound barriers to health and wellness coaching, but I do think it is very beneficial, as we've seen in both of our cohorts. Encouraging everyone—if you are in a state of readiness—to maybe seek a health coach, maybe talk to one of your other providers about it, and really explore it more.

Transcript edited for clarity. Click here for more coverage of CMSC 2025.

REFERENCES
1. Boehmer KR, Álvarez-Villalobos NA, Barakat S, et al. The impact of health and wellness coaching on patient-important outcomes in chronic illness care: A systematic review and meta-analysis. Patient Educ Couns. 2023;117:107975. doi:10.1016/j.pec.2023.107975
2. Kivelä K, Elo S, Kyngäs H, Kääriäinen M. The effects of health coaching on adult patients with chronic diseases: a systematic review. Patient Educ Couns. 2014;97(2):147-157. doi:10.1016/j.pec.2014.07.026
3. Moore C. The Power of Health Coaching. Presented at: 2025 CMSC Annual Meeting; May 28-31; Phoenix, AZ. Thriving with MS: Harnessing Wellness Research & the Power of Health Coaching.