Online Acceptance-based Behavioural Treatment for Fibromyalgia
30 de novembro de 2015 atualizado por: 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.
Visão geral do estudo
Status
Concluído
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Intervencional
Inscrição (Real)
67
Estágio
- Fase 3
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Locais de estudo
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Manitoba
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Winnipeg, Manitoba, Canadá, R3A 1R9
- Health Sciences Centre
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Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
18 anos e mais velhos (Adulto, Adulto mais velho)
Aceita Voluntários Saudáveis
Não
Gêneros Elegíveis para o Estudo
Tudo
Descrição
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.
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Comparador Ativo: 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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Experimental: 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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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change from baseline in Fibromyalgia Impact Questionnaire-revised
Prazo: 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
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change from baseline in Center for Epidemiological Studies Depression Scale
Prazo: Baseline, 2 months, 5 months
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Evaluation of depressive symptoms
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Baseline, 2 months, 5 months
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Change from baseline in Chronic Pain Acceptance Questionnaire
Prazo: Baseline, 2 months, 5 months
|
Overall acceptance of chronic pain
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Baseline, 2 months, 5 months
|
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Change from baseline in Cognitive Fusion Questionnaire
Prazo: Baseline, 2 months, 5 months
|
Evaluation of fusion with thoughts
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Baseline, 2 months, 5 months
|
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Change from baseline in McGill Pain Questionnaire- short form
Prazo: Baseline, 2 months, 5 months
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subjective measure of type and severity of pain
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Baseline, 2 months, 5 months
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Change from baseline in Five Facet Mindfulness Questionnaire
Prazo: Baseline, 2 months, 5 months
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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
Prazo: Baseline, 2 months, 5 months
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Measure of sleep quality and quantity
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Baseline, 2 months, 5 months
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Change from baseline in Tampa Scale of Kinesiophobia-11
Prazo: Baseline, 2 months, 5 months
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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
Prazo: 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
Prazo: 2 months
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unpublished scale evaluating the impact of treatment on symptoms, and how useful participants found the treatment protocol
|
2 months
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Investigadores
- Investigador principal: Heather Simister, MA, University of Manitoba
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo
1 de setembro de 2012
Conclusão Primária (Real)
1 de agosto de 2014
Conclusão do estudo (Real)
1 de agosto de 2015
Datas de inscrição no estudo
Enviado pela primeira vez
25 de junho de 2012
Enviado pela primeira vez que atendeu aos critérios de CQ
15 de julho de 2012
Primeira postagem (Estimativa)
17 de julho de 2012
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
2 de dezembro de 2015
Última atualização enviada que atendeu aos critérios de controle de qualidade
30 de novembro de 2015
Última verificação
1 de novembro de 2015
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- H2012:179
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