TY - JOUR
T1 - Effectiveness of a psychoeducational treatment program implemented in general practice for fibromyalgia patients
T2 - A randomized controlled trial
AU - Luciano, Juan V.
AU - Martínez, Nuria
AU - Peñarrubia-María, Maria Teresa
AU - Fernández-Vergel, Rita
AU - García-Campayo, Javier
AU - Verduras, Camino
AU - Blanco, María E.
AU - Jiménez, Mónica
AU - Ruiz, José M.
AU - Del Hoyo, Yolanda López
AU - Serrano-Blanco, Antoni
N1 - Funding Information:
The research project and Nuria Martínez's predoctoral contract are funded by a grant from the “Agència d'Avaluació de Tecnologia i Recerca Mèdiques” ( AATRM 077/25/06 ). Juan V. Luciano received a postdoctoral contract from the “Instituto de Salud Carlos III” ( Red RD06/0018/0017 ).
PY - 2011/6
Y1 - 2011/6
N2 - Objectives: A recent meta-analysis concluded that multicomponent treatments are effective for some fibromyalgia (FM) symptoms. The objective of this study was to examine whether a psychoeducational intervention implemented in primary care is more effective than usual care for improving the functional status of patients with FM. Methods: This study was based on a randomized controlled trial. The 484 patients with FM included in a database of the Viladecans Hospital (Barcelona, Spain) were eligible for screening. Finally, 108 patients were randomly assigned to the intervention and 108 patients were assigned to usual care. The intervention comprised nine 2-hour sessions (5 sessions of education and 4 sessions of autogenic relaxation). The patients were assessed before and after the intervention with a battery of instruments (measuring sociodemographic data, medical comorbidities, functional status, trait anxiety, and social desirability). Results: The posttreatment drop-out rate was 9.7% (intervention: 6.5%; control: 13%). The intention-to-treat analyses showed significant differences between the groups at posttreatment: the intervention group improved in physical impairment, days not feeling well, pain, general fatigue, morning fatigue, stiffness, anxiety, and depression (medium effect size in most cases). The patients who responded to the intervention reported less trait anxiety at baseline than nonresponders. The absolute risk reduction with the intervention was 36.1% (95% confidence interval: 23.3-48.8) and the number needed to treat was 3 (95% confidence interval: 2.0-4.3). Discussion: A 2-month psychoeducational intervention improves the functional status of FM patients to a greater extent than usual care, at least in the short-term. The social desirability bias did not explain the reported outcomes. Trait anxiety was associated with response to treatment. TRIAL REGISTRATION: NCT00550966.
AB - Objectives: A recent meta-analysis concluded that multicomponent treatments are effective for some fibromyalgia (FM) symptoms. The objective of this study was to examine whether a psychoeducational intervention implemented in primary care is more effective than usual care for improving the functional status of patients with FM. Methods: This study was based on a randomized controlled trial. The 484 patients with FM included in a database of the Viladecans Hospital (Barcelona, Spain) were eligible for screening. Finally, 108 patients were randomly assigned to the intervention and 108 patients were assigned to usual care. The intervention comprised nine 2-hour sessions (5 sessions of education and 4 sessions of autogenic relaxation). The patients were assessed before and after the intervention with a battery of instruments (measuring sociodemographic data, medical comorbidities, functional status, trait anxiety, and social desirability). Results: The posttreatment drop-out rate was 9.7% (intervention: 6.5%; control: 13%). The intention-to-treat analyses showed significant differences between the groups at posttreatment: the intervention group improved in physical impairment, days not feeling well, pain, general fatigue, morning fatigue, stiffness, anxiety, and depression (medium effect size in most cases). The patients who responded to the intervention reported less trait anxiety at baseline than nonresponders. The absolute risk reduction with the intervention was 36.1% (95% confidence interval: 23.3-48.8) and the number needed to treat was 3 (95% confidence interval: 2.0-4.3). Discussion: A 2-month psychoeducational intervention improves the functional status of FM patients to a greater extent than usual care, at least in the short-term. The social desirability bias did not explain the reported outcomes. Trait anxiety was associated with response to treatment. TRIAL REGISTRATION: NCT00550966.
KW - education
KW - Fibromyalgia
KW - primary care
KW - randomized controlled trial
KW - relaxation
UR - http://www.scopus.com/inward/record.url?scp=79955799684&partnerID=8YFLogxK
U2 - 10.1097/AJP.0b013e31820b131c
DO - 10.1097/AJP.0b013e31820b131c
M3 - Article
AN - SCOPUS:79955799684
SN - 0749-8047
VL - 27
SP - 383
EP - 391
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
IS - 5
ER -