Internet-based Exposure-based Therapy for Fibromyalgia: A Randomized Controlled Trial.
13. prosince 2016 aktualizováno: Erik Andersson, Karolinska Institutet
The purpose of this study is to examine if an internet-based exposure therapy is effective in reducing Fibromyalgia symptoms and impact amongst patients with Fibromyalgia.
Přehled studie
Postavení
Dokončeno
Podmínky
Intervence / Léčba
Detailní popis
Trial Objectives: Primary objective is to investigate whether an Internet-based exposure therapy can effectively reduce the degree of Fibromyalgia symptoms and impact. Secondary objectives are to 1) investigate the treatment's ability to reduce degree of a) quality of life b) function c) insomnia and fatigue d) pain-related fear and negative thoughts e) depression and anxiety, cost-effectiveness of this treatment; and 2) to study if any variables could moderate/mediate the treatment outcome, such as a) degree of covert avoidance, b) degree of reactivity to inner sensations
Trial Design: Randomized controlled trial with waitlist control, who also will receive treatment after the first group has finished.
Duration: Ten weeks
Primary Endpoint: Change in Fibromyalgia symptoms and impact from baseline to Week 10. Long term follow-up is also investigated (potential changes from post-treatment to 6- and 12 months after treatment completion)
Efficacy Parameters: the Fibromyalgia Impact Questionnaire (FIQ)
Description of Trial Subjects: Patients > 18 years old, Fibromyalgia diagnosis, residing in Sweden.
Number of Subjects: 140
Sample size estimation: Sample size is based on a estimated effect size (measured by Cohen's d) of 0.5, based on a power of 0.8 and with room for a 10 % dropout rate.
Recruitment: Self-referral. Advertising will be made through national newspaper, social media and on patient organisations' websites.
Safety parameters: Participants will have the opportunity to report any adverse events during treatment at posttreatment and follow-up measurements.
Data collection: Data will be collected electronically via the treatment platform.
Plan for missing data: Last-observation carried forward (LOCF).
Main statistical analysis: Hierarchical linear mixed modelling.
Typ studie
Intervenční
Zápis (Aktuální)
140
Fáze
- Nelze použít
Kontakty a umístění
Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.
Studijní místa
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Stockholm
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Solna, Stockholm, Švédsko, 17177
- Karolinska Institutet
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Kritéria účasti
Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.
Kritéria způsobilosti
Věk způsobilý ke studiu
18 let až 100 let (Dospělý, Starší dospělý)
Přijímá zdravé dobrovolníky
Ne
Pohlaví způsobilá ke studiu
Všechno
Popis
Inclusion Criteria:
- Fibromyalgia diagnosis
- Swedish resident
- Internet connection before, under and after treatment
- Willing to refrain from other concurrent psychological treatment during the study
- Agreement to keep psychotrophic medication constant during the study
Exclusion Criteria:
- Severe depression (≥30 points on Montgomery Åsberg Depression Rating Scale - Self Rated (MADRS-S) or risk of suicide (≥4 points on the suicide item on MADRS-S)
- Ongoing alcohol or substance abuse
- Psychosis
- Other severe illness that require immediate treatment and/or was considered the participants primary concern other than FM, or bodily condition that makes treatment unfeasible (such as late pregnancy; >29 weeks gestation
- Illiteracy or poor skills in Swedish language
- Insufficient computer or language skills to manage a text-based treatment.
- Other concurrent psychological treatment
- Recent changes in psychotrophic medication (<6 weeks prior to randomization)
Studijní plán
Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
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Experimentální: Internet-based exposure therapy
The experimental group will go through active internet-based treatment which is delivered on a safe internet platform.
Treatment is divided into eight modules, each containing homework assignments.
Participants in experimental group will be assigned a therapist that they can contact through a message system in the platform and expect answer within 48 hours.
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The treatment is a 10 week long cognitive behavior therapy.
It is based mainly on the principles of exposure; i.e. the participant is instructed to approach situations they have avoided in order to reduce or avoid pain or other aversive experiences until they feel less discomfort and extended behavior repertoire in presence of pain and aversive inner experiences Other interventions include psychoeducation, mindfulness and acceptance strategies and are employed in order to facilitate exposure.
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Žádný zásah: Waitlist
Waitlist control, i.e. no active active intervention during waiting list period.
Will be offered treatment when the first group has finished (i.e.
week 10).
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Change in the Fibromyalgia Impact Questionnaire (FIQ)
Časové okno: Week 0, week 10, Long term follow-up at 6- and 12-months after treatment has ended]
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Change in Fibromyalgia symptoms and impact from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, Long term follow-up at 6- and 12-months after treatment has ended]
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Insomnia Severity Index (ISI)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in sleep disturbances from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Fatigue Severity Scale (FSS)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in fatigue from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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WHO Disability Assessment Schedule 2.0 (WHODAS 2)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in level of function from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Brunnsviken Brief Quality of Life Inventory (BBQ)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in quality of life from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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The Psychological Inflexibility in Pain Scale (PIPS)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in covert avoidance from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Pain Reactivity Scale (PRS)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in pain-related fear and negative thoughts from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Patient Health Questionnaire-9 (PHQ-9)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in level of depression from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Generalised Anxiety Disorder 7-item scale (GAD-7)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in level of anxiety from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Subscale "reactivity to inner experiences" from Five Facets of Mindfulness Questionnaire (FFMQ)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in reactivity to inner experiences from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Trimbos and Institute of Medical Technology Assessment Cost Questionnaire for Psychiatry (TIC-P)
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in health-care costs and sick-leave from baseline to Week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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EQ5D
Časové okno: Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Change in health-related quality of life from baseline to week 10, and at 6- and 12 months after treatment has ended.
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Week 0, week 10, follow-up at 6- and 12-months after treatment has ended
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Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Item 9 from Montgomery Asberg Depression Rating Scale (MADRS-S)
Časové okno: Week 1, week 2, week 3, week 4, week 5, week 6, week, 7, week 8, week 9
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Possible presence of suicidal thoughts or ideation during treatment
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Week 1, week 2, week 3, week 4, week 5, week 6, week, 7, week 8, week 9
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Spolupracovníci a vyšetřovatelé
Zde najdete lidi a organizace zapojené do této studie.
Sponzor
Termíny studijních záznamů
Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.
Hlavní termíny studia
Začátek studia
1. prosince 2015
Primární dokončení (Aktuální)
1. července 2016
Dokončení studie (Aktuální)
1. července 2016
Termíny zápisu do studia
První předloženo
17. prosince 2015
První předloženo, které splnilo kritéria kontroly kvality
19. prosince 2015
První zveřejněno (Odhad)
23. prosince 2015
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
14. prosince 2016
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
13. prosince 2016
Naposledy ověřeno
1. prosince 2016
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
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