Online Acceptance-based Behavioural Treatment for Fibromyalgia
30 de noviembre de 2015 actualizado por: 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.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
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.
Tipo de estudio
Intervencionista
Inscripción (Actual)
67
Fase
- Fase 3
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
-
-
Manitoba
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Winnipeg, Manitoba, Canadá, R3A 1R9
- Health Sciences Centre
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
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.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Comparador activo: Treatment-as-usual
Participants continue their pre-study treatment plan, based on their physician/other professional recommendations
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Participants will continue pre-study treatment under their current licensed practitioners.
Intervention may include drug treatment, physical therapy, or other
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Experimental: 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.
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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
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Change from baseline in Fibromyalgia Impact Questionnaire-revised
Periodo de tiempo: baseline, 2 months, 5 months
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Assesses overall impact of Fibromyalgia symptoms on daily functioning
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baseline, 2 months, 5 months
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Change from baseline in Center for Epidemiological Studies Depression Scale
Periodo de tiempo: Baseline, 2 months, 5 months
|
Evaluation of depressive symptoms
|
Baseline, 2 months, 5 months
|
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Change from baseline in Chronic Pain Acceptance Questionnaire
Periodo de tiempo: Baseline, 2 months, 5 months
|
Overall acceptance of chronic pain
|
Baseline, 2 months, 5 months
|
|
Change from baseline in Cognitive Fusion Questionnaire
Periodo de tiempo: Baseline, 2 months, 5 months
|
Evaluation of fusion with thoughts
|
Baseline, 2 months, 5 months
|
|
Change from baseline in McGill Pain Questionnaire- short form
Periodo de tiempo: Baseline, 2 months, 5 months
|
subjective measure of type and severity of pain
|
Baseline, 2 months, 5 months
|
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Change from baseline in Five Facet Mindfulness Questionnaire
Periodo de tiempo: Baseline, 2 months, 5 months
|
Measure of mindfulness skills
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Baseline, 2 months, 5 months
|
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Change from baseline in Pittsburgh Sleep Quality Index
Periodo de tiempo: Baseline, 2 months, 5 months
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Measure of sleep quality and quantity
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Baseline, 2 months, 5 months
|
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Change from baseline in Tampa Scale of Kinesiophobia-11
Periodo de tiempo: Baseline, 2 months, 5 months
|
Measure of fear of movement
|
Baseline, 2 months, 5 months
|
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Change from baseline in Valued Living Questionnaire
Periodo de tiempo: Baseline, 2 months, 5 months
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Measure of values, and how consistently one lives those values
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Baseline, 2 months, 5 months
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Global Assessment Scale
Periodo de tiempo: 2 months
|
unpublished scale evaluating the impact of treatment on symptoms, and how useful participants found the treatment protocol
|
2 months
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Investigador principal: Heather Simister, MA, University of Manitoba
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de septiembre de 2012
Finalización primaria (Actual)
1 de agosto de 2014
Finalización del estudio (Actual)
1 de agosto de 2015
Fechas de registro del estudio
Enviado por primera vez
25 de junio de 2012
Primero enviado que cumplió con los criterios de control de calidad
15 de julio de 2012
Publicado por primera vez (Estimar)
17 de julio de 2012
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
2 de diciembre de 2015
Última actualización enviada que cumplió con los criterios de control de calidad
30 de noviembre de 2015
Última verificación
1 de noviembre de 2015
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- H2012:179
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .