Effectiveness of a structured group intervention based on pain neuroscience education for patients with fibromyalgia in primary care: A multicentre randomized open‐label controlled trial
Background There has been increased interest in pain neuroscience education (PNE) as a therapeutic approach for the management of fibromyalgia (FM). Methods A multicentre randomized, open‐label, controlled trial was conducted to assess the effectiveness of a structured group intervention based on PN...
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| Published in: | European journal of pain Vol. 25; no. 5; pp. 1137 - 1149 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
John Wiley and Sons Inc
01-05-2021
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background
There has been increased interest in pain neuroscience education (PNE) as a therapeutic approach for the management of fibromyalgia (FM).
Methods
A multicentre randomized, open‐label, controlled trial was conducted to assess the effectiveness of a structured group intervention based on PNE in patients with FM. A total of 139 patients were included in the study and randomized to the intervention group (7 group sessions of education in neurobiology of pain) or to the control group (treatment as usual only). The primary outcome was the improvement of functional status and pain measured with the Fibromyalgia Impact Questionnaire (FIQ), and secondary outcomes were the reduction in the impact of pain and other symptoms (catastrophizing, anxiety and depression) and number of patients reaching no worse than moderate functional impairment (FIQ score <39). Differences between groups were calculated by linear mixed‐effects (intention‐to‐treat approach) and mediational models through path analyses.
Results
At 1 year, improvements in FIQ scores were higher in the intervention group with moderate or high effect size, and decreases of ≥20% in 69.1% of patients (20.9% in the control group) and of ≥50% in 39.7% (4.5% in the control group). Also, 52.9% of patients had a FIQ <39 points (13.4% in the control group).
Conclusions
In this sample of patients with FM, the improvement in quality of life and control of symptoms obtained by adding a PNE intervention showed promising results, equalling or surpassing previously reported outcomes.
Significance
A structured group intervention based on pain neuroscience education for 1 year in patients with fibromyalgia was associated with significant amelioration of the impact of the disease on scores of the Fibromyalgia Impact Questionnaire, the Health Assessment Questionnaire, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale and the Polysymptomatic Distress Scale as compared with only treatment as usual. These findings are clinically relevant considering the challenges posed by fibromyalgia to clinicians and patients alike. |
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| Bibliography: | Funding information None of the authors received any funding to support this work. Partial reduction of routine work tasks of the principal investigator, MJ Barrenengoa‐Cuadra, was supported by a grant from OSI Bilbao Basurto Osakidetza, Basque country, Spain (the grant was paid to the Health Service to substitute MJ Barrenengoa‐Cuadra while research work). Members of the FIMIDOC Working Group (Osatzen Working Group on Fibromyalgia, Migraine and Chronic Pain) researchers who participated in the study: M.J. Barrenengoa‐Cuadra, M. Muñoa‐Capron‐Manieux, R. Gracia‐Ballarín, M. Fernández‐Luco, L. A. Angón‐Puras, A.J. Romón‐Gómez, M. Azkuenaga, A. Etxebarria, G. Orrantia, A. Pikaza, L. Uribe‐Etxebarria and A. Zorrilla ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-News-2 ObjectType-Feature-3 content type line 23 |
| ISSN: | 1090-3801 1532-2149 |
| DOI: | 10.1002/ejp.1738 |