Community-based Intervention for Fibromyalgia: A Pilot Trial
7 de octubre de 2019 actualizado por: Nelly Oelke, University of British Columbia
A Multi-disciplinary, Community-based Group Intervention for Fibromyalgia: A Pilot Randomized Controlled Trial
Fibromyalgia (FM) is a multi-factorial chronic pain condition characterized by fluctuating and heterogeneous symptoms.
This leads to both reduced patient function and quality of life and consequentially, significant economic burden on the society.
Although numerous pharmaceutical and multi-treatment approaches exist, there is lack of an integrated multidisciplinary model of care for these patients.
Such a system is hypothesized to be beneficial for the patients and would help them regain function and significantly improve their quality of life.
The primary aim of this pilot clinical trial is to evaluate the effectiveness of an integrated community-based multidisciplinary model of care for FM patients in Penticton and surrounding areas.
The comprehensive 10 week intervention will provide care from a team of health care providers (psychiatrist, physiotherapist, certified exercise therapist, dietitian, rheumatologist, and mental health clinician).
Patients will also attend a peer led pain self-management support group provided by the Arthritis Society.
The study aims at educating these patients about self-management of their symptoms such as chronic pain, weight, sleep and mood disorders.
The integration of health care between the different providers will be achieved by "huddle" sessions that will be conducted on a monthly basis.
The evaluation of the study outcomes will be based on the RE-AIM framework.
Data will be collected through patient questionnaires, healthcare utilization data, and interviews with providers.
Data analysis will involve thematic analysis of qualitative data and statistical methods for quantitative data.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Intervencionista
Inscripción (Actual)
84
Fase
- No aplica
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
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British Columbia
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Penticton, British Columbia, Canadá, V2A 4Z1
- Balfour Medical 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
19 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- formal diagnosis of FM
- resident of Penticton or surrounding area
- adults, aged 19 and older
- fluent in English or bring a family member/friend to assist with translation
- capacity to provide informed consent
Exclusion Criteria:
- patients with a severe and/or chronic medical or psychiatric condition that would impact ability to participate in the intervention
- patients who are pregnant or lactating
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: Investigación de servicios de salud
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Multidisciplinary intervention
The 10-week intervention will include twice weekly 1-2 hours sessions with multiple professional team members to undergo education and exercise sessions.
The multidisciplinary team will consist of a rheumatologist, rheumatology nurse, dietitian, physiotherapist, a trained exercise therapist, a physiologist who specializes in pain management, a psychiatrist and a mental health clinician.
All intervention team members have expertise in working with individuals with chronic pain conditions.
General disease information, current best practices and techniques such as self-pain management, pacing, sleep hygiene, approach to a healthy lifestyle and weight loss will be discussed.
The total number of hours for the 10 week intervention is 31 hours.
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10 week multidisciplinary education and exercise
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Sin intervención: Usual care
Usual care involves being referred to the local rheumatologist involved in the study.
The rheumatologist and the rheumatology nurse will see the control group patients during a one hour one on one consultation appointment.
During that time the patient's history will be taken, physical exam performed and investigations analyzed.
If a diagnosis of fibromyalgia is confirmed, the rheumatologist and nurse will counsel the patient and provide resources for self directed management.
Unless there is a concern of an alternative diagnosis, follow up will not be arranged.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Patient-perceived quality of care
Periodo de tiempo: Change from baseline in perceived quality of care at 10 weeks and 6 months
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Patient assessment of care received as measured by the Patient Assessment of Chronic Illness Care Questionnaire
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Change from baseline in perceived quality of care at 10 weeks and 6 months
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Daily function #1
Periodo de tiempo: Change from baseline in daily function at 10 weeks and 6 months
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Physical disease and mental health related functioning as measured by Revised-Fibromyalgia Impact Questionnaire
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Change from baseline in daily function at 10 weeks and 6 months
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Daily function #2
Periodo de tiempo: Change from baseline in daily function at 10 weeks and 6 months
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Mental health related functioning as measured by Hospital Anxiety and Depression scale
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Change from baseline in daily function at 10 weeks and 6 months
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Health care utilization (physician visits)
Periodo de tiempo: Change from baseline in physician visits at 6 months
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Number of physician visits
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Change from baseline in physician visits at 6 months
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Health care utilization (emergency visits)
Periodo de tiempo: Change from baseline in emergency department visits at 6 months
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Number of emergency department visits
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Change from baseline in emergency department visits at 6 months
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Sleep quality
Periodo de tiempo: Change from baseline in sleep quality at 10 weeks
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Quality of sleep as measured by Sleep scale - medical outcome scale
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Change from baseline in sleep quality at 10 weeks
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Sleep quality
Periodo de tiempo: Change from baseline in sleep quality at 6 months
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Quality of sleep as measured by Sleep scale - medical outcome scale
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Change from baseline in sleep quality at 6 months
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Attitudes of pain
Periodo de tiempo: Change from baseline in pain attitudes at 10 weeks and 6 months
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Measurement of pain through Survey of brief attitudes of pain
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Change from baseline in pain attitudes at 10 weeks and 6 months
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Irritability
Periodo de tiempo: Change from baseline in irritability at 10 weeks
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Irritability measured by Brief Irritability Test (BITe) questionnaire
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Change from baseline in irritability at 10 weeks
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Irritability
Periodo de tiempo: Change from baseline in irritability at 6 months
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Irritability measured by Brief Irritability Test (BITe) questionnaire
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Change from baseline in irritability at 6 months
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Patient perspectives on self-management resources
Periodo de tiempo: 10 weeks
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Questionnaire to be administered to gather patient perspectives on self-management resources offered via hard copy, online, and social media
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10 weeks
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Patient perspectives on self-management resources
Periodo de tiempo: 6 months
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Questionnaire to be administered to gather patient perspectives on self-management resources offered via hard copy, online, and social media
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6 months
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Provider perspectives on quality of care
Periodo de tiempo: 18 months
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Interviews will be conducted to gather providers' perspectives on the model of care
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18 months
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Investigador principal: Michelle Teo, University of British Columbia
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Publicaciones Generales
- Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther. 2009;11(4):R120. doi: 10.1186/ar2783. Epub 2009 Aug 10. Erratum In: Arthritis Res Ther. 2009;11(5):415.
- Fitzcharles MA, Ste-Marie PA, Goldenberg DL, Pereira JX, Abbey S, Choiniere M, Ko G, Moulin DE, Panopalis P, Proulx J, Shir Y; National Fibromyalgia Guideline Advisory Panel. 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary. Pain Res Manag. 2013 May-Jun;18(3):119-26. doi: 10.1155/2013/918216.
- Schaefer C, Chandran A, Hufstader M, Baik R, McNett M, Goldenberg D, Gerwin R, Zlateva G. The comparative burden of mild, moderate and severe fibromyalgia: results from a cross-sectional survey in the United States. Health Qual Life Outcomes. 2011 Aug 22;9:71. doi: 10.1186/1477-7525-9-71.
- Lachaine J, Beauchemin C, Landry PA. Clinical and economic characteristics of patients with fibromyalgia syndrome. Clin J Pain. 2010 May;26(4):284-90. doi: 10.1097/AJP.0b013e3181cf599f.
- Thompson JM, Luedtke CA, Oh TH, Shah ND, Long KH, King S, Branda M, Swanson R. Direct medical costs in patients with fibromyalgia: Cost of illness and impact of a brief multidisciplinary treatment program. Am J Phys Med Rehabil. 2011 Jan;90(1):40-6. doi: 10.1097/PHM.0b013e3181fc7ff3.
- Winkelmann A, Perrot S, Schaefer C, Ryan K, Chandran A, Sadosky A, Zlateva G. Impact of fibromyalgia severity on health economic costs: results from a European cross-sectional study. Appl Health Econ Health Policy. 2011 Mar 1;9(2):125-36. doi: 10.2165/11535250-000000000-00000.
- Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE, Blonna D. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat. 2012;2012:426130. doi: 10.1155/2012/426130. Epub 2012 Nov 4. Erratum In: Pain Res Treat. 2013;2013:960270.
- Gaglio B, Shoup JA, Glasgow RE. The RE-AIM framework: a systematic review of use over time. Am J Public Health. 2013 Jun;103(6):e38-46. doi: 10.2105/AJPH.2013.301299. Epub 2013 Apr 18.
- Richards L, Morse J. Read me first for a users guide to qualitative methods. (3rd ed.) Sage Publications, Inc. 2013.
- Verbeke G, Molenberghs G. Linear Mixed Models for Longitudinal Data. Springer Science & Business Media; 2009.
- Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, Greene SM. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care. 2005 May;43(5):436-44. doi: 10.1097/01.mlr.0000160375.47920.8c.
- Nam S, Tin D, Bain L, Thorne JC, Ginsburg L. Clinical utility of the Hospital Anxiety and Depression Scale (HADS) for an outpatient fibromyalgia education program. Clin Rheumatol. 2014 May;33(5):685-92. doi: 10.1007/s10067-013-2377-1. Epub 2013 Sep 1.
- Cappelleri JC, Bushmakin AG, McDermott AM, Dukes E, Sadosky A, Petrie CD, Martin S. Measurement properties of the Medical Outcomes Study Sleep Scale in patients with fibromyalgia. Sleep Med. 2009 Aug;10(7):766-70. doi: 10.1016/j.sleep.2008.09.004. Epub 2009 Jan 29.
- Tait RC, Chibnall JT. Development of a brief version of the Survey of Pain Attitudes. Pain. 1997 Apr;70(2-3):229-35. doi: 10.1016/s0304-3959(97)03330-7.
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 (Actual)
15 de septiembre de 2017
Finalización primaria (Actual)
30 de junio de 2019
Finalización del estudio (Actual)
30 de junio de 2019
Fechas de registro del estudio
Enviado por primera vez
21 de agosto de 2017
Primero enviado que cumplió con los criterios de control de calidad
31 de agosto de 2017
Publicado por primera vez (Actual)
1 de septiembre de 2017
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
9 de octubre de 2019
Última actualización enviada que cumplió con los criterios de control de calidad
7 de octubre de 2019
Última verificación
1 de octubre de 2019
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- H17-01782
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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. .
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