Targeting Daily Positive Events to Improve Emotional and Functional Well-Being in Adults With Fibromyalgia: Insights From the LARKSPUR Randomized Controlled Trial.

BACKGROUND

Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties, affecting individuals across all age groups. Positive affect (PA) interventions have shown promise in enhancing emotional well-being and pain management in patients with diverse chronic pain conditions. However, the efficacy of internet-delivered PA interventions for individuals with fibromyalgia remains understudied.

OBJECTIVE

This randomized controlled trial investigated the efficacy of a web-based PA regulation intervention-Lessons in Affect Regulation to Keep Stress and Pain Under Control (LARKSPUR)-in enhancing emotional and functional well-being among adults with fibromyalgia syndrome.

METHODS

A total of 95 participants with fibromyalgia syndrome aged 50 years and older (89/95, 94% female) were randomized to one of two fully automated conditions: (1) LARKSPUR (n=49) or (2) emotion reporting/attention control (n=46). At the postintervention and 1-month follow-up time points, participants completed 7 consecutive, end-of-day, web-based reports capturing positive events (PE), pain, fatigue, PA, and negative affect.

RESULTS

Compared to control, LARKSPUR resulted in greater improvements in daily affective responsivity to PE at the postintervention time point, including greater reductions in negative affect (b-b=-0.06, 95% highest posterior density interval [HPD] -0.10 to -0.02) and increases in PA (b-b=0.10, 95% HPD 0.02-0.19). Furthermore, across the postintervention and 1-month follow-up time points, LARKSPUR led to greater reductions in pain (b-b=-0.20, 95% HPD -0.36 to -0.04) and fatigue (b-b=-0.24, 95% HPD -0.41 to -0.06) following PE.

CONCLUSIONS

This randomized controlled trial provides initial evidence that a web-based PA skills intervention can enhance emotional well-being and reduce pain and fatigue in aging adults with fibromyalgia.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04869345; https://clinicaltrials.gov/study/NCT04869345.