TY - JOUR
T1 - Effectiveness of group acceptance and commitment therapy for fibromyalgia
T2 - A 6-month randomized controlled trial (EFFIGACT study)
AU - Luciano, Juan V.
AU - Guallar, José A.
AU - Aguado, Jaume
AU - López-Del-Hoyo, Yolanda
AU - Olivan, Bárbara
AU - Magallón, Rosa
AU - Alda, Marta
AU - Serrano-Blanco, Antoni
AU - Gili, Margalida
AU - Garcia-Campayo, Javier
N1 - Funding Information:
The authors would like to thank Marta Puebla and Mari Cruz Pérez-Yus for assistance with the data collection. Juan V. Luciano received a research contract from the Institute of Health Carlos III (Red RD06/0018/0017 ). Appendix A
PY - 2014/4
Y1 - 2014/4
N2 - In the last decade, there has been burgeoning interest in the effectiveness of third-generation psychological therapies for managing fibromyalgia (FM) symptoms. The present study examined the effectiveness of acceptance and commitment therapy (ACT) on functional status as well as the role of pain acceptance as a mediator of treatment outcomes in FM patients. A total of 156 patients with FM were enrolled at primary health care centers in Zaragoza, Spain. The patients were randomly assigned to a group-based form of ACT (GACT), recommended pharmacological treatment (RPT; pregabalin + duloxetine), or wait list (WL). The primary end point was functional status (measured with the Fibromyalgia Impact Questionnaire, FIQ). Secondary end points included pain catastrophizing, pain acceptance, pain, anxiety, depression, and health-related quality of life. The differences between groups were calculated by linear mixed-effects (intention-to-treat approach) and mediational models through path analyses. Overall, GACT was statistically superior to both RPT and WL immediately after treatment, and improvements were maintained at 6 months with medium effect sizes in most cases. Immediately after treatment, the number needed to treat for 20% improvement compared to RPT was 2 (95% confidence interval 1.2-2.0), for 50% improvement 46, and for achieving a status of no worse than mild impaired function (FIQ total score <39) also 46. Unexpectedly, 4 of the 5 tested path analyses did not show a mediation effect. Changes in pain acceptance only mediated the relationship between study condition and health-related quality of life. These findings are discussed in relation to previous psychological research on FM treatment.
AB - In the last decade, there has been burgeoning interest in the effectiveness of third-generation psychological therapies for managing fibromyalgia (FM) symptoms. The present study examined the effectiveness of acceptance and commitment therapy (ACT) on functional status as well as the role of pain acceptance as a mediator of treatment outcomes in FM patients. A total of 156 patients with FM were enrolled at primary health care centers in Zaragoza, Spain. The patients were randomly assigned to a group-based form of ACT (GACT), recommended pharmacological treatment (RPT; pregabalin + duloxetine), or wait list (WL). The primary end point was functional status (measured with the Fibromyalgia Impact Questionnaire, FIQ). Secondary end points included pain catastrophizing, pain acceptance, pain, anxiety, depression, and health-related quality of life. The differences between groups were calculated by linear mixed-effects (intention-to-treat approach) and mediational models through path analyses. Overall, GACT was statistically superior to both RPT and WL immediately after treatment, and improvements were maintained at 6 months with medium effect sizes in most cases. Immediately after treatment, the number needed to treat for 20% improvement compared to RPT was 2 (95% confidence interval 1.2-2.0), for 50% improvement 46, and for achieving a status of no worse than mild impaired function (FIQ total score <39) also 46. Unexpectedly, 4 of the 5 tested path analyses did not show a mediation effect. Changes in pain acceptance only mediated the relationship between study condition and health-related quality of life. These findings are discussed in relation to previous psychological research on FM treatment.
KW - Acceptance and commitment therapy
KW - Fibromyalgia
KW - Pain acceptance
KW - Psychological therapy
UR - http://www.scopus.com/inward/record.url?scp=84896397518&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2013.12.029
DO - 10.1016/j.pain.2013.12.029
M3 - Article
C2 - 24378880
AN - SCOPUS:84896397518
SN - 0304-3959
VL - 155
SP - 693
EP - 702
JO - Pain
JF - Pain
IS - 4
ER -