Impact of interdisciplinary treatment on physical and psychosocial parameters in patients with fibromyalgia: results of a randomised trial

Abstract

An interdisciplinary intervention may be appropriate for patients referred to a hospital pain management unit.

Effectiveness of physical and cognitive-behavioural intervention programmes for chronic musculoskeletal pain in adults: A systematic review and meta-analysis of randomised controlled trials

“…Amongst the studies, two compared the combined intervention with waitlist control [26,35] and three with usual care [29,33,34]. One study compared the combined intervention with pharmacological therapy as treatment as usual [32]. Fourteen studies compared it to physical exercise alone [19–25,27,28,30,31,33,35,36], whereas only three used CBT alone [25,33,35] as a comparison group for the combined intervention.…”

“…One study [34] used patients’ diaries to score pain intensity but did not describe the scoring method. After excluding this study, a total of 12 studies reported follow-up outcomes on pain intensity [20–27,29,31,32,36], although not all reported post-intervention outcomes at the same time. Note that one of these studies [21] was listed as having 1-year follow-up outcomes, but in fact the CBT component of the combined intervention continued on a monthly basis after the conclusion of the main intervention; this needs to be taken into consideration when interpreting the results.…”

“…Two studies [25,32] reported small to medium effects ( g = 0.24–0.50), mostly at ~5 months of follow-up, for patients with osteoarthritis and fibromyalgia, while again three studies by Monticone and colleagues [21,23,24] reported quite large effects ( g = 1.27–3.97) up to 2-year follow-ups for patients with neck and low back pain. These effects were obtained with exercise alone [21,23–25], CBT alone [25], or pharmacological treatment [32] as control. Note that one study [33] analysed chronic pain grade, a measure combining pain intensity and disability, and did not find any effect at post-intervention or follow-up.…”

“…Bennell and colleagues [25] found moderate effects up to 40-week follow-up ( d ~0.50) against CBT alone, but not against the exercise-alone programme. Martin and colleagues [32] also found a small effect at 20-week follow-up ( g = 0.45) against pharmacological treatment. And again, the studies by Monticone and colleagues [21–24] reported large effects up to 2-year follow-up ( g = 1.71–5.49).…”

“…Only five studies assessed mood or mental symptoms, including depressive symptoms, anxiety, general psychological distress (General Health Questionnaire) and mental health (SF-36 Mental Component) at post-intervention or follow-up [25,27,32,33,35]. Only two of these studies found partial support for the effect of the combined intervention.…”