There were two studies on multidisciplinary programs at the ACR 2015 Annual Meeting in San Francisco. I would have like to see more studies, but still …
Amrita Kaur Bath and colleagues presented this study: “Immediate Benefits of a Multidisciplinary Educational Program for Fibromyalgia on Patients’ Pain Related Self-Efficacy and Health Locus of Control”. They looked at 77 female patients, who met the ACR 2010 preliminary criteria for fibromyalgia, and took part in participated in an 3.5 hour educational program. “The program was rated very or extremely helpful by 79.7% of patients, with 78.6% reporting getting answers to most or all their questions. Results showed significant increases in PSEQ [Pain Related Self Efficacy Questionnaire] (p < 0.0001), and decreases in external locus of control MHLC [Multidimensional Health Locus of Control Scale] “chance” (p < 0.0001). Conclusion: “These results show that a brief multidisciplinary educational program in FM [Fibromyalgia] can significantly enhance self efficacy related to pain and external attributions in patients with severe FM and moderate depression. Our study supports the utility of short education programs on positive coping for FM patients.”
Though I like this study, I must utter a word or two of caution. Knowing “about clinical, pathophysiologic, and therapeutic aspects of FM; exercise instruction, orientation on the cognitive behavioral model of pain and stress, review of psychosocial contributors to chronic pain, family education, and introduction to relaxation techniques“ in 3.5 hours doesn’t mean that everything has been understood or that anything will change. One needs to looks at long term effects. Could these patients change anything in daily life? I think education is the first and right step on a way to behavioral changes.
The second study by N. Halliday and colleagues is a systematic review: “Effectiveness of Multidisciplinary Pain Rehabilitation Programs for Patients with Fibromyalgia Syndrome: A Systematic Review”. “After screening 11,280 abstracts, nine RCT’s (1216 patients) met the inclusion criteria.” “Comparison groups included waiting list control with exercise, pharmacological treatment, less intensive MPRP’s [multidisciplinary pain rehabilitation program], and no intervention.” “A meta-analysis revealed that MPRP’s are effective in the long term at reducing to pain levels (…) and disease impact (…). The narrative synthesis revealed moderate to low quality evidence in support of MPRP’s FMS.” Conclusion: “These findings suggest that MPRP have a positive impact on long-term pain levels and disease impact in people with FMS. (…)”
I work in a setting, where multimodal/multidisciplinary pain intervention is the rule for fibromyalgia patients as current health policy and insurance conditions don’t allow other treatments. Therefore I have a great interest in these studies. These studies support our own efforts in multidisciplinary pain programs, which include education, physical/sport therapy, behavioural therapy. Thanks for that!
Bath AK, Gota CE, Morales Cavolo A, Davin S. Immediate Benefits of a Multidisciplinary Educational Program for Fibromyalgia on Patients’ Pain Related Self-Efficacy and Health Locus of Control [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/immediate-benefits-of-a-multidisciplinary-educational-program-for-fibromyalgia-on-patients-pain-related-self-efficacy-and-health-locus-of-control/. Accessed November 12, 2015.
Halliday N, Treanor C, Galvin R, Brooks J. Effectiveness of Multidisciplinary Pain Rehabilitation Programs for Patients with Fibromyalgia Syndrome: A Systematic Review [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/effectiveness-of-multidisciplinary-pain-rehabilitation-programs-for-patients-with-fibromyalgia-syndrome-a-systematic-review/. Accessed November 12, 2015.
Fibromyalgia: Multimodal Therapy at the Rheinische Rheuma Zentrum