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Online Acceptance-based Behavioural Treatment for Fibromyalgia

2015년 11월 30일 업데이트: 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.

연구 개요

상세 설명

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.

연구 유형

중재적

등록 (실제)

67

단계

  • 3단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Manitoba
      • Winnipeg, Manitoba, 캐나다, R3A 1R9
        • Health Sciences Centre

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

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.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
활성 비교기: Treatment-as-usual
Participants continue their pre-study treatment plan, based on their physician/other professional recommendations
Participants will continue pre-study treatment under their current licensed practitioners. Intervention may include drug treatment, physical therapy, or other
실험적: 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.
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

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change from baseline in Fibromyalgia Impact Questionnaire-revised
기간: baseline, 2 months, 5 months
Assesses overall impact of Fibromyalgia symptoms on daily functioning
baseline, 2 months, 5 months

2차 결과 측정

결과 측정
측정값 설명
기간
Change from baseline in Center for Epidemiological Studies Depression Scale
기간: Baseline, 2 months, 5 months
Evaluation of depressive symptoms
Baseline, 2 months, 5 months
Change from baseline in Chronic Pain Acceptance Questionnaire
기간: Baseline, 2 months, 5 months
Overall acceptance of chronic pain
Baseline, 2 months, 5 months
Change from baseline in Cognitive Fusion Questionnaire
기간: Baseline, 2 months, 5 months
Evaluation of fusion with thoughts
Baseline, 2 months, 5 months
Change from baseline in McGill Pain Questionnaire- short form
기간: Baseline, 2 months, 5 months
subjective measure of type and severity of pain
Baseline, 2 months, 5 months
Change from baseline in Five Facet Mindfulness Questionnaire
기간: Baseline, 2 months, 5 months
Measure of mindfulness skills
Baseline, 2 months, 5 months
Change from baseline in Pittsburgh Sleep Quality Index
기간: Baseline, 2 months, 5 months
Measure of sleep quality and quantity
Baseline, 2 months, 5 months
Change from baseline in Tampa Scale of Kinesiophobia-11
기간: Baseline, 2 months, 5 months
Measure of fear of movement
Baseline, 2 months, 5 months
Change from baseline in Valued Living Questionnaire
기간: Baseline, 2 months, 5 months
Measure of values, and how consistently one lives those values
Baseline, 2 months, 5 months
Global Assessment Scale
기간: 2 months
unpublished scale evaluating the impact of treatment on symptoms, and how useful participants found the treatment protocol
2 months

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Heather Simister, MA, University of Manitoba

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2012년 9월 1일

기본 완료 (실제)

2014년 8월 1일

연구 완료 (실제)

2015년 8월 1일

연구 등록 날짜

최초 제출

2012년 6월 25일

QC 기준을 충족하는 최초 제출

2012년 7월 15일

처음 게시됨 (추정)

2012년 7월 17일

연구 기록 업데이트

마지막 업데이트 게시됨 (추정)

2015년 12월 2일

QC 기준을 충족하는 마지막 업데이트 제출

2015년 11월 30일

마지막으로 확인됨

2015년 11월 1일

추가 정보

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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