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Community-based Intervention for Fibromyalgia: A Pilot Trial

7 octobre 2019 mis à jour par: 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.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Réel)

84

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Canada
    • British Columbia
      • Penticton, British Columbia, Canada, V2A 4Z1
        • Balfour Medical Centre

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

19 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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 d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Recherche sur les services de santé
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 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.
Autre: Multidisciplinary intervention
10 week multidisciplinary education and exercise
Aucune intervention: 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.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Patient-perceived quality of care
Délai: Change from baseline in perceived quality of care at 10 weeks and 6 months
Patient assessment of care received as measured by the Patient Assessment of Chronic Illness Care Questionnaire
Change from baseline in perceived quality of care at 10 weeks and 6 months

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Daily function #1
Délai: Change from baseline in daily function at 10 weeks and 6 months
Physical disease and mental health related functioning as measured by Revised-Fibromyalgia Impact Questionnaire
Change from baseline in daily function at 10 weeks and 6 months
Daily function #2
Délai: Change from baseline in daily function at 10 weeks and 6 months
Mental health related functioning as measured by Hospital Anxiety and Depression scale
Change from baseline in daily function at 10 weeks and 6 months
Health care utilization (physician visits)
Délai: Change from baseline in physician visits at 6 months
Number of physician visits
Change from baseline in physician visits at 6 months
Health care utilization (emergency visits)
Délai: Change from baseline in emergency department visits at 6 months
Number of emergency department visits
Change from baseline in emergency department visits at 6 months

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Sleep quality
Délai: Change from baseline in sleep quality at 10 weeks
Quality of sleep as measured by Sleep scale - medical outcome scale
Change from baseline in sleep quality at 10 weeks
Sleep quality
Délai: Change from baseline in sleep quality at 6 months
Quality of sleep as measured by Sleep scale - medical outcome scale
Change from baseline in sleep quality at 6 months
Attitudes of pain
Délai: Change from baseline in pain attitudes at 10 weeks and 6 months
Measurement of pain through Survey of brief attitudes of pain
Change from baseline in pain attitudes at 10 weeks and 6 months
Irritability
Délai: Change from baseline in irritability at 10 weeks
Irritability measured by Brief Irritability Test (BITe) questionnaire
Change from baseline in irritability at 10 weeks
Irritability
Délai: Change from baseline in irritability at 6 months
Irritability measured by Brief Irritability Test (BITe) questionnaire
Change from baseline in irritability at 6 months
Patient perspectives on self-management resources
Délai: 10 weeks
Questionnaire to be administered to gather patient perspectives on self-management resources offered via hard copy, online, and social media
10 weeks
Patient perspectives on self-management resources
Délai: 6 months
Questionnaire to be administered to gather patient perspectives on self-management resources offered via hard copy, online, and social media
6 months
Provider perspectives on quality of care
Délai: 18 months
Interviews will be conducted to gather providers' perspectives on the model of care
18 months

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

University of British Columbia

Collaborateurs

Interior Health
Canadian Rheumatology Association

Les enquêteurs

  • Chercheur principal: Michelle Teo, University of British Columbia

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

15 septembre 2017

Achèvement primaire (Réel)

30 juin 2019

Achèvement de l'étude (Réel)

30 juin 2019

Dates d'inscription aux études

Première soumission

21 août 2017

Première soumission répondant aux critères de contrôle qualité

31 août 2017

Première publication (Réel)

1 septembre 2017

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

9 octobre 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

7 octobre 2019

Dernière vérification

1 octobre 2019

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • H17-01782

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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