[Effectiveness of pain neuroscience education in patients with fibromyalgia: Structured group intervention in Primary Care]

María Jesús Barrenengoa-Cuadra, Luis Ángel Angón-Puras, José Ignacio Moscosio-Cuevas, Jesús González-Lama, Marian Fernández-Luco, Rafael Gracia-Ballarín, María Jesús Barrenengoa-Cuadra, Luis Ángel Angón-Puras, José Ignacio Moscosio-Cuevas, Jesús González-Lama, Marian Fernández-Luco, Rafael Gracia-Ballarín

Abstract

Objective: To evaluate the effectiveness of a group intervention in Primary Care in patients with fibromyalgia (FM) based on pain neuroscience education (PNE).

Design: Pre-post study.

Location: Urban Primary Health Centre in Bilbao.

Participants: Patients with FM (2010 American College of Rheumatology Diagnostic Criteria for fibromyalgia), ≥18 years.

Intervention: 5 weekly sessions (2hours each), and a reminder session one month later.

Main measurements: Compliance with FM criteria, assessed using the WPI (Widespread Pain Index, number of pain areas) and the SS (severity of symptoms) questionnaires. An assessment was also made on the impact of FM on functional capacity (FIQ:≥20% and ≥50% reduction in the FIQ total score from baseline to after treatment, and proportion of patients with FIQ<39 at the end of the study). Assessments were made at baseline, one month following the 5th session, and during the 6- and 12-month follow-up.

Results: All the study evaluations were completed by 85/98 patients. A statistically significant improvement was observed in the 3 studied categories (WPI, SS, and FIQ) since the first visit, and was maintained until the final visit (12 months later). A total of 45 patients (53%, 95% CI: 42%-63%), more than those at baseline, scored FIQ<39 (no worse than mild functional impairment). One month following the 5th session there were 44 patients (52%, 95% CI: 41%-62%) that no longer met FM criteria and, at the end of follow-up, there were 56 patients (66%, 95% CI: 55%-75%).

Conclusions: An intervention based on PNE has shown to be feasible in Primary Care, with results in the upper range of those published with other treatments for FM.

Keywords: Central nervous system sensitisation; Chronic pain; Dolor crónico; Educación del paciente; Fibromialgia; Fibromyalgia; Neurociencia; Neuroscience; Patient education; Sensibilización del sistema nervioso central.

Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7752966/bin/fx1.jpg
Esquema del estudio. Estudio de intervención antes-después.
Figura 1
Figura 1
Pacientes que alcanzan cada punto de corte fijado según la puntuación del Fibromyalgia Impact Questionnaire (FIQ) a lo largo del estudio (N = 85). IC: Intervalo de confianza al 95%; V0: evaluación basal; V1: evaluación al mes; V2: evaluación a los 6 meses; V3: evaluación a los 12 meses (final).

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