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Online Acceptance-based Behavioural Treatment for Fibromyalgia

30. november 2015 opdateret af: Heather Simister, University of Manitoba

Online Acceptance-Based Behavioural Treatment for Fibromyalgia

A recent study published by the Canadian Pain Society estimated the direct health care costs of chronic pain to be about 6 billion dollars. Over 1/3 of all Canadians reported that they either missed work or experienced reduced productivity due to chronic pain. Fibromyalgia Syndrome (FMS)is a condition that affects up to 10% of the Canadian population, many of whom are still in the prime of their lives. While pain and fatigue are prominent symptoms, FMS sufferers often experience sleep disturbance, gastrointestinal upset, chronic headache, memory and thinking problems, and depression. Standard treatments focus on medication and physical exercise but are not always successful. Acceptance-Based behavioural therapy (ABBT) is a relatively new approach that has been effective not only in treating mental health concerns such as anxiety and depression, but also other medical conditions such as diabetes and chronic pain. A novel ABBT for FMS was developed and pilot tested with a small group of participants. The results of this preliminary study were promising. Unfortunately, many people cannot adequately access available treatment due to long wait lists, prohibitive costs, or time/location constraints. Online treatments may offer improved access to care without reducing the effectiveness of treatment. Therefore, the ABBT for FMS used in the pilot study is being adapted to an online format and will be evaluated with a larger group of participants. A wait-list/control group will be employed to evaluate the effectiveness of the online treatment as compared with treatment-as-usual. If found effective, this treatment would offer patients easier access to care at a significantly reduced cost to the health care system.

Studieoversigt

Detaljeret beskrivelse

The current study extended a pilot study (Shay, Tkachuk, Simister, Bailly, & Skrabek, 2011), modifying the previous treatment to a 6 unit program that could be delivered online. Sixty-one participants completed the study, being randomly assigned to an online ABBT plus treatment-as-usual (online ABBT + TAU) group or a treatment-as-usual alone (TAU) group. All participants completed a series of self-report measures at baseline, at post-treatment, and at a 3-month follow-up. Linear mixed modelling supported significant differences between the groups in favour of the ABBT + TAU treatment group on the primary outcome measure (Fibromyalgia Impact Questionnaire-Revised (FIQ-R); F (2, 52.82) = 20.10, p < .0001) following treatment. The online ABBT + TAU group also had significantly greater improvements in depression, pain, acceptance, perceived helplessness, and kinesiophobia. Increased acceptance mediated the effects of treatment on improvements in FMS quality of life and FMS impact, while reduced helplessness mediated the effects of treatment on improvements in level of reported pain. Comments and subjective ratings of improvement were consistent with the quantitative results. Participants rated mindfulness (contact with present moment experience) as the most useful treatment unit.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

67

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Manitoba
      • Winnipeg, Manitoba, Canada, R3A 1R9
        • Health Sciences Centre

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Participants of either sex aged 18 years and older with a formal diagnosis of FMS will be recruited.
  • Individuals younger than 18 years of age will be excluded in order to ensure all participants have reached the age of majority and can provide consent.
  • They will have a pain intensity rating of at least 4/10 based on self-report. Participants will also be screened using the Wolfe et al (2010) criteria during the in-person session to ensure they meet criteria for FMS.
  • Must reside in and complete study from within Manitoba, Canada

Exclusion Criteria:

  • People with co-morbidities such as rheumatologic conditions, other conditions affecting the immune system (e.g. chronic fatigue syndrome, multiple sclerosis, lupus), brain injury, cognitive impairment that would limit a participant's ability to complete informed consent, active psychosis, substance abuse, uncontrolled major depression or bipolar disorder, active suicidality, or those who have current active injury claims will be excluded.
  • Given the use of a large amount of reading materials, participants will be asked if they have completed at least grade 9 in high school. Those who have only completed grade 8 or lower will be excluded.
  • Further, participants will be asked to maintain their pre-study treatment regime and not making changes to their medications or beginning other treatments for the duration of the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Treatment-as-usual
Participants continue their pre-study treatment plan, based on their physician/other professional recommendations
Participants will continue pre-study treatment under their current licensed practitioners. Intervention may include drug treatment, physical therapy, or other
Eksperimentel: Online ABBT treatment + TAU
Participants to complete a 6-unit online Acceptance-based behavioural treatment including training in pacing, mindfulness, acceptance, cognitive defusion, willingness, and exercise while also maintaining their pre-study treatment.
Participants will continue pre-study treatment under their current licensed practitioners. Intervention may include drug treatment, physical therapy, or other
Behavioral intervention focusing on acceptance, mindfulness and values-based living instead of focus on symptom control

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change from baseline in Fibromyalgia Impact Questionnaire-revised
Tidsramme: baseline, 2 months, 5 months
Assesses overall impact of Fibromyalgia symptoms on daily functioning
baseline, 2 months, 5 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change from baseline in Center for Epidemiological Studies Depression Scale
Tidsramme: Baseline, 2 months, 5 months
Evaluation of depressive symptoms
Baseline, 2 months, 5 months
Change from baseline in Chronic Pain Acceptance Questionnaire
Tidsramme: Baseline, 2 months, 5 months
Overall acceptance of chronic pain
Baseline, 2 months, 5 months
Change from baseline in Cognitive Fusion Questionnaire
Tidsramme: Baseline, 2 months, 5 months
Evaluation of fusion with thoughts
Baseline, 2 months, 5 months
Change from baseline in McGill Pain Questionnaire- short form
Tidsramme: Baseline, 2 months, 5 months
subjective measure of type and severity of pain
Baseline, 2 months, 5 months
Change from baseline in Five Facet Mindfulness Questionnaire
Tidsramme: Baseline, 2 months, 5 months
Measure of mindfulness skills
Baseline, 2 months, 5 months
Change from baseline in Pittsburgh Sleep Quality Index
Tidsramme: Baseline, 2 months, 5 months
Measure of sleep quality and quantity
Baseline, 2 months, 5 months
Change from baseline in Tampa Scale of Kinesiophobia-11
Tidsramme: Baseline, 2 months, 5 months
Measure of fear of movement
Baseline, 2 months, 5 months
Change from baseline in Valued Living Questionnaire
Tidsramme: Baseline, 2 months, 5 months
Measure of values, and how consistently one lives those values
Baseline, 2 months, 5 months
Global Assessment Scale
Tidsramme: 2 months
unpublished scale evaluating the impact of treatment on symptoms, and how useful participants found the treatment protocol
2 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Heather Simister, MA, University of Manitoba

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2012

Primær færdiggørelse (Faktiske)

1. august 2014

Studieafslutning (Faktiske)

1. august 2015

Datoer for studieregistrering

Først indsendt

25. juni 2012

Først indsendt, der opfyldte QC-kriterier

15. juli 2012

Først opslået (Skøn)

17. juli 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

2. december 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. november 2015

Sidst verificeret

1. november 2015

Mere information

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Fibromyalgi syndrom

3
Abonner