Background Very positive effects have been described in the application of pain neuroscience education (PNE) to chronic pain and migraine. However, there are few data on the applicability of this therapeutic approach in actual clinical practice in a primary care (PC) setting. The aim of this study was to explore the efficacy in fibromyalgia (FM) of an intervention based on PNE and exercise compared to treatment as usual (TAU). Methods Pragmatic nonrandomised controlled trial set in 5 healthcare centres and one physiotherapy centre in PC. Fifty-three women with FM (2010 American College of Rheumatology Diagnostic Criteria for Fibromyalgia) were studied, 35 in the intervention group (IG) and 18 in the control group (CG). The women in the IG were interviewed individually and then received 6 weekly sessions plus one review session (1 month later): those in the CG received their TAU. The subject assignation to the CG or the IG was determined according to their availability to attend the sessions. They all filled in several questionnaires (prior to and 1 year after the intervention) to evaluate the impact of FM in their daily lives, catastrophism, anxiety and depression, severity and impact of pain in daily personal performance and functional capacity. Results The reductions (improvements) in the scores of all tests (baseline-final) were greater in the IG (p < 0.05) when adjusted for age and baseline values, with moderate or high effect size. After 1 year, 20% (CI − 1 to 42%) more women in the IG, compared to the CG, had a FIQ score < 39 (mild functional impairment). 17/38 (49%) women in the IG no longer met FM criteria at the end of follow-up. Conclusions An intervention based on PNE and exercise in patients with FM is feasible and seems effective in PC. Trial registration The study was retrospectively registered at ClinicalTrials.gov (Trial Registration NCT04539171), on 04/09/2020.
Objetivo Evaluar la efectividad de una intervención grupal en atención primaria en pacientes con fibromialgia (FM), basada en la educación en neurociencia del dolor ( Pain Neuroscience Education , PNE). Diseño Estudio de intervención antes-después. Emplazamiento Centro de Salud urbano de Bilbao. Participantes Pacientes con FM (criterios diagnósticos 2010 del American College of Rheumatology ), ≥ 18 años. Intervención Cinco sesiones semanales (2 h cada una), y una sesión de recuerdo un mes después. Mediciones principales Cumplimiento de criterios de FM, mediante los cuestionarios WPI (número de áreas de dolor) y SS (gravedad de los síntomas), e impacto de la FM sobre la capacidad funcional (FIQ: reducción ≥ 20% y ≥ 50% sobre la puntuación basal, y proporción de pacientes con FIQ < 39 al final del estudio). Se hicieron evaluaciones al inicio, al mes de la 5. a sesión, 6 y 12 meses después. Resultados Completaron todas las evaluaciones del estudio 85/98 pacientes. Se objetivó una mejoría estadísticamente significativa en las 3 categorías estudiadas (WPI, SS y FIQ) desde la primera visita, mantenida hasta la visita final (12 meses después). Cuarenta y cinco pacientes (53%, IC: 42-63%) más que al inicio tuvieron una puntuación en el FIQ < 39 (impacto funcional no grave). Al mes de finalizar la 5. a sesión había 44 (52%, IC: 41-62%) que ya no cumplían criterios de FM y al final del seguimiento 56 (66%, IC: 55-75%). Conclusiones Una intervención basada en PNE ha mostrado ser factible en atención primaria, con resultados en el rango superior de los publicados con otros tratamientos para FM.
Background and objective: Health professionals and students in training are key for early diagnosis of cancer. The objective of this study was to evaluate the degree of awareness of Family and Community Medicine (FCM) residents and Medicine and Nursing undergraduate students in Spain regarding the European Code against Cancer (ECAC).
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