A patient's perspective on multidisciplinary treatment gain for fibromyalgia: an indicator for pre-post treatment effects?

Abstract

Objective: Increasing attention is devoted to the patient's perspective in clinical research and practice. However, the relationship between the patient's view on treatment progress and standardized pre-post changes in health outcomes is not well understood. The objective of this study was to investigate whether the patient's perception of treatment gain converges with pre-post treatment effects of a multidisciplinary treatment as assessed by standardized self-report measures.

Methods: During a tailored multidisciplinary treatment for fibromyalgia, validated self-report questionnaires were assessed at baseline and posttreatment on the outcome measures of pain, functional disability, fatigue, anxiety, and negative mood. In addition, the participants were asked to fill in a questionnaire at the end of the treatment assessing the patient's perception of improvement on core outcomes, as well as satisfaction and usefulness of the treatment.

Results: Moderate to relatively high correlations were found between the patient's perception of improvement and pre-post changes on the physical outcomes, in contrast to small or nonsignificant correlations for psychological outcomes. In addition, satisfaction and usefulness were significantly related to pre-post changes on physical outcomes, but no relationship was found with respect to psychological outcomes.

Conclusion: Results suggest that the patient's perception of treatment gain and pre-post changes in outcomes during treatment assess different aspects of the patient's treatment progress, particularly with regard to psychological functioning. Future research on clinical improvements should consider the patient's perception of treatment gain as an independent and clinically relevant outcome, in addition to standardized trial data of pre-post assessments of health outcomes.

Trial registration: ClinicalTrials.gov NCT00268606.