Online Acceptance-based Behavioural Treatment for Fibromyalgia
30 november 2015 bijgewerkt door: 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.
Studie Overzicht
Toestand
Voltooid
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
67
Fase
- Fase 3
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Manitoba
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Winnipeg, Manitoba, Canada, R3A 1R9
- Health Sciences Centre
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar en ouder (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
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.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Actieve vergelijker: Treatment-as-usual
Participants continue their pre-study treatment plan, based on their physician/other professional recommendations
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Participants will continue pre-study treatment under their current licensed practitioners.
Intervention may include drug treatment, physical therapy, or other
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Experimenteel: 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.
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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
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change from baseline in Fibromyalgia Impact Questionnaire-revised
Tijdsspanne: baseline, 2 months, 5 months
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Assesses overall impact of Fibromyalgia symptoms on daily functioning
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baseline, 2 months, 5 months
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change from baseline in Center for Epidemiological Studies Depression Scale
Tijdsspanne: Baseline, 2 months, 5 months
|
Evaluation of depressive symptoms
|
Baseline, 2 months, 5 months
|
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Change from baseline in Chronic Pain Acceptance Questionnaire
Tijdsspanne: Baseline, 2 months, 5 months
|
Overall acceptance of chronic pain
|
Baseline, 2 months, 5 months
|
|
Change from baseline in Cognitive Fusion Questionnaire
Tijdsspanne: Baseline, 2 months, 5 months
|
Evaluation of fusion with thoughts
|
Baseline, 2 months, 5 months
|
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Change from baseline in McGill Pain Questionnaire- short form
Tijdsspanne: Baseline, 2 months, 5 months
|
subjective measure of type and severity of pain
|
Baseline, 2 months, 5 months
|
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Change from baseline in Five Facet Mindfulness Questionnaire
Tijdsspanne: Baseline, 2 months, 5 months
|
Measure of mindfulness skills
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Baseline, 2 months, 5 months
|
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Change from baseline in Pittsburgh Sleep Quality Index
Tijdsspanne: Baseline, 2 months, 5 months
|
Measure of sleep quality and quantity
|
Baseline, 2 months, 5 months
|
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Change from baseline in Tampa Scale of Kinesiophobia-11
Tijdsspanne: Baseline, 2 months, 5 months
|
Measure of fear of movement
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Baseline, 2 months, 5 months
|
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Change from baseline in Valued Living Questionnaire
Tijdsspanne: Baseline, 2 months, 5 months
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Measure of values, and how consistently one lives those values
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Baseline, 2 months, 5 months
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Global Assessment Scale
Tijdsspanne: 2 months
|
unpublished scale evaluating the impact of treatment on symptoms, and how useful participants found the treatment protocol
|
2 months
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Heather Simister, MA, University of Manitoba
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 september 2012
Primaire voltooiing (Werkelijk)
1 augustus 2014
Studie voltooiing (Werkelijk)
1 augustus 2015
Studieregistratiedata
Eerst ingediend
25 juni 2012
Eerst ingediend dat voldeed aan de QC-criteria
15 juli 2012
Eerst geplaatst (Schatting)
17 juli 2012
Updates van studierecords
Laatste update geplaatst (Schatting)
2 december 2015
Laatste update ingediend die voldeed aan QC-criteria
30 november 2015
Laatst geverifieerd
1 november 2015
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- H2012:179
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