Community-based Intervention for Fibromyalgia: A Pilot Trial
2019년 10월 7일 업데이트: 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.
연구 개요
연구 유형
중재적
등록 (실제)
84
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 장소
-
-
British Columbia
-
Penticton, British Columbia, 캐나다, V2A 4Z1
- Balfour Medical 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
19년 이상 (성인, 고령자)
건강한 자원 봉사자를 받아들입니다
아니
연구 대상 성별
모두
설명
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
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 건강 서비스 연구
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: 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.
|
10 week multidisciplinary education and exercise
|
|
간섭 없음: 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.
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Patient-perceived quality of care
기간: 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
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Daily function #1
기간: 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
기간: 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)
기간: 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)
기간: 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
|
기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Sleep quality
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 18 months
|
Interviews will be conducted to gather providers' perspectives on the model of care
|
18 months
|
공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Michelle Teo, University of British Columbia
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
일반 간행물
- 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.
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 (실제)
2017년 9월 15일
기본 완료 (실제)
2019년 6월 30일
연구 완료 (실제)
2019년 6월 30일
연구 등록 날짜
최초 제출
2017년 8월 21일
QC 기준을 충족하는 최초 제출
2017년 8월 31일
처음 게시됨 (실제)
2017년 9월 1일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2019년 10월 9일
QC 기준을 충족하는 마지막 업데이트 제출
2019년 10월 7일
마지막으로 확인됨
2019년 10월 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. .
Multidisciplinary intervention에 대한 임상 시험
-
VA Office of Research and Development모집하지 않고 적극적으로
-
Washington University School of MedicineSt. Jude Children's Research Hospital완전한
-
University of MichiganNational Institute on Drug Abuse (NIDA)모병
-
RTI InternationalUniversity of North Carolina, Chapel Hill초대로 등록결절성 경화증 | 다운 증후군 | 뒤시엔 근이영양증 | 프래더-윌리 증후군 | 취약 X 증후군 | 레트 증후군 | 터너 증후군 | 윌리엄스 증후군 | 엔젤만 증후군 | 염색체 22q11.2 결실 증후군 | 클라인펠터 증후군 | 펠란-맥더미드 증후군 | Dup15Q 증후군 | 스미스 마제니스 증후군미국
-
University of MichiganNational Institute of Nursing Research (NINR)완전한
-
University of MichiganNational Center for Advancing Translational Sciences (NCATS)완전한