Multi-disciplinary community-based group intervention for fibromyalgia: a pilot randomized controlled trial

Abstract

Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances, mood disturbances, and cognitive impairment. Most individuals with fibromyalgia experience poorly managed symptoms and increased healthcare service use. Multicomponent therapies, with a focus on nonpharmacological modalities, are increasingly supported in the literature. However, given the limited resources available, implementation in smaller communities remains a challenge. This research tested a community-based multidisciplinary group intervention for individuals diagnosed with FM living in a small urban centre. The primary outcome was perceptions of quality of care and secondary outcomes included disease-related functioning, anxious and depressive symptoms, pain beliefs, and health service utilization. A pilot randomized control trial was conducted in which 60 patients diagnosed with fibromyalgia were randomized into a 10-week community-based multidisciplinary group intervention program or usual care. Treatment components included twice-weekly exercise sessions and weekly education sessions (e.g., pain education, cognitive behavioral strategies for stress, nutrition, peer support). The trial (NCT03270449) was registered September 1 2017. Statistically significant post-intervention improvements were found in the primary outcome, perceived quality of care (Cohen’s d = 0.61, 0.66 for follow up care and goal setting, respectively). Secondary outcomes showing statistically significant improvements were disease-related daily functioning (Cohen’s d = 0.70), depressive symptoms (Cohen’s d = 0.87), and pain beliefs (Cohen’s d = 0.61, 0.67, 0.82 for harm, disability and control, respectively). No adverse events were reported. Community-based multidisciplinary group interventions for fibromyalgia show promise for improving satisfaction with quality of care, disease-related functioning, and depression, and fostering more adaptive pain beliefs.

Resilience and Sense of Coherence among Female Fibromyalgia Patients Living in a Conflict Zone Who Underwent Fibrotherapy Intervention

“…Most treatments for FM patients address pain, imbalance, and sleep disorders. However, a few studies proposed to follow a program for resilience and sense of coherence among patients [58,59].…”

Usefulness of a Multicomponent Group Intervention Program for Fibromyalgia Patients in Primary Care: A Qualitative Study of Health Professionals

“…Multicomponent treatments are currently considered the "gold standard" along with maintaining individualized care [3]. Recent quantitative studies are confirming the effectiveness of some multicomponent treatments for FM patients [6,8,[25][26][27]. It is essential that strategies be tested to promote equality of care across different settings.…”

The effect of earthquake on fibromyalgia: a comparison of patients on medication and without medication

“…The management of fibromyalgia typically necessitates a comprehensive strategy including multiple disciplines and should be customized to address the specific symptoms and requirements of each individual [ 7 ]. Depending on the clinician’s preference and the patient’s compliance, pharmacological agents such as tricyclic antidepressants, serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and gabapentinoid drugs (GDs) are used in the treatment [ 8 , 9 ].…”