Fibromyalgia has been increasing worldwide and is considered a public health problem. Nonpharmacological treatment through exercise and education is recommended for fibromyalgia management. In this sense, there is a need for interdisciplinary programs to promote health and improve symptoms in fibromyalgia. The purpose of this study was to verify the effectiveness of interdisciplinary health education programs for individuals with fibromyalgia. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations and was registered at Prospective Register of Systematic Reviews (CRD4201913228). A search was conducted in the following databases: Scientific Electronic Library Online, Lilacs, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Knowledge ISI, Physiotherapy Evidence Database, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and SPORTDiscus. The descriptors used were “Fibromyalgia” and “Health Education.” Clinical trials published between 1990 and 2019 were selected. The Jadad Quality Scale and the Cochrane Risk-of-Bias Tool were used to evaluate the risk of bias and the methodological quality of the clinical trials. The search found 2887 articles, and only two studies were included in the analysis. Both studies conducted the interventions through lectures and group activities. In particular, the topics most frequently approached at the interdisciplinary health education programs were general information about fibromyalgia, body practices, physical activities, and pharmacological approaches. An interdisciplinary health education program can improve pain and quality of life in people with fibromyalgia; however, evidence shows low methodological quality. This systematic review indicates that studies are of low quality, interfering with the effectiveness of interdisciplinary health education programs.
Background“Amigos de Fibro” (Fibro Friends), is a recent and innovative program created from the joint action of patients and health professionals, which can be an effective educational tool to be implemented in primary health care centers, promoting self-care, quality of life and health promotion in individuals with fibromyalgia in Brazil.ObjectivesEvaluate the effectiveness of an interdisciplinary health promotion educational program called “Amigos de Fibro” in improving pain intensity, symptom severity, quality of life, sleep quality and self-care agency in individuals with fibromyalgia in Brazil.MethodsA randomized clinical trial was carried out with 24 participants divided into two groups: the experimental group (EG) and the control group (CG). The EG group held online meetings through the Google Meet platform with an interdisciplinary team (10 professionals) that worked in primary health care in Brazil, where they gave lectures and held debates and dynamics on the importance of health promotion and self-care in fibromyalgia. In addition, participants performed a physical exercise protocol. The “Amigos de Fibro” protocol has been previously published and showed good agreement. The control group (CG) received an education and self-care e-book for fibromyalgia that addressed information similar to the EG (http://www.amigosdefibro.com.br). Participants were assessed pre and post-intervention. A descriptive analysis of the data was performed, as well as the differences of the independent variables between the intervention and control groups were studied using Student’s t test for independent samples. A significance level of 5% was adopted.ResultsThe mean age of the participants was 38.7±9.4 years for the EG and 44.9±10.6 for the CG, all (100%) of whom were female in both groups. Compared to the baseline, all EG variables and only the FIQ symptoms domain of the CG showed significant improvements (p<0.005), however, the other CG variables showed improvements, but they were not significant (Table 1).Table 1.Results of the variables studied in both groups.EGCGPre-interventionPost-interventionp-valuePre-interventionPost-interventionp-valueMean±SDMean±SDMean±SDMean±SDGDI14±3,28,3±3,0<0,001*13,8±2,511,5±3,70,066SS10,3±1,86,9±2,70,001*10,8±1,010,1±1,40,244FIQ-RFunction21,0±4,610,6±4,8<0,001*21,4±4,719,3±5,40,128Global16,1±5,18,1±4,20,002*16,5±2,613,8±3,60,016Symptoms37,3±5,723,2±8,1<0,001*39,4±5,134,3±7,80,004*Total score74,6±12,842±15,1<0,001*77,3±9,667,5±14,60,006VAS7,8±1,04,7±2,2<0,001*7,7±1,56,9±2,40,193Sleep16,7±2,011,9±4,20,001*16,2±2,615,8±4,20,664Self-care51,3±6,863,6±5,60,001*53,1±7,349,1±11,10,251Caption:EG: Experimental Group; CG: Control Group; SD: Standard deviation; GDI: Generalized Pain Index; SS: Severity of Symptoms; FIQ-R: The Revised Fibromyalgia Impact Questionnaire; VAS: Visual Analog Pain Scale.Conclusion“Amigos de Fibro”, a light technology in health, was considered with good results and improvement of all studied variables that address the main aspects that promote the health of individuals with fibromyalgia and, therefore, being considered valid for use by health professionals with the target public in primary health care in Brazil, enabling them to act as health promoting agents. Our next steps are to expand knowledge of this program to other countries.References[1]Antunes MD, Schmitt ACB, Marques AP. Amigos de Fibro (Fibro Friends): development of an educational program for the health promotion of fibromyalgia patients. Primary Health Care Research & Development. 2022;23(e44):1–7.https://doi.org/10.1017/S1463423621000773[2]Antunes MD, Schmitt ACB, Marques AP. Amigos de Fibro (Fibro Friends): Validation of an Educational Program to Promote Health in Fibromyalgia. International Journal of Environmental Research and Public Health. 2022;19(9):e5297.https://doi.org/10.3390/ijerph19095297AcknowledgementsThis study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001Disclosure of InterestsNone Declared.
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