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!
References:
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
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