Caballol Angelats Rosa, Gonçalves Alessandra Queiroga, Abellana Rosa, Carrasco-Querol Noèlia, Pàmies Corts Anna, González Serra Gemma, Gràcia Benaiges Dolors, Sancho Sol Maria Cinta, Fusté Anguera Immaculada, Chavarria Jordana Susana, Cuevas Baticón Blanca, Batlle Escolies Gemma, Fibla Reverté Maria, Espuny Vallés Noemí, Buera Pitarque Núria, Martí Cavallé Montserrat, Suazo Nuria Piñana, Estivill Bargalló Joan, López Guerrero Maria Àngels, López Guerrero Carolina, Pérez Acín Pilar, Matamoros Callarisa Immaculada, Baucells Jordi, Suazo Ciurana Adrià, Fernández-Sáez José, Dalmau Llorca M Rosa, Berenguera Anna, Aguilar Martín Carina
Unitat d'Expertesa en Síndromes de Sensibilització Central Terres de l'Ebre, Institut Català de la Salut, 43500 Tortosa, Spain.
Programa de Doctorat Medicina i Recerca Translacional, Departament de Fonaments Clínics, Facultat de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain.
J Clin Med. 2024 Dec 30;14(1):161. doi: 10.3390/jcm14010161.
: Multicomponent, non-pharmacological therapies are the preferred first-line treatments for fibromyalgia (FM), but little is known about them in primary care settings. Our study assessed the effectiveness of the FIBROCARE Program in improving the quality of life, functional impact, mood, and pain of people with FM. : We conducted a pragmatic, randomized controlled trial that was not blinded for both patients and the professionals delivering the treatments in the study groups. We compared a group receiving non-pharmacological multicomponent group therapy (MT) based on health education, physical exercise, and cognitive-behavioral therapy with another group receiving the usual clinical care. The MT group was treated in the primary care context in Catalonia (Spain) through 12 consecutive weekly sessions. Both groups were followed up with at the end of the MT group sessions and 6 and 12 months after the group sessions with the Short-Form 36 (SF-36) v2 Health Survey questionnaire, the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the Visual Analog Scale, and the Revised Fibromyalgia Impact Questionnaire (ClinicalTrials.gov: NCT04049006). : Improvements in pain intensity, functional impact, physical health, fatigue, and emotional problems that affect daily activities in the MT group lasted up to 12 months. Benefits measured by the SF-36 Mental Health dimension and the HADS-A subscale were lost after 6 months. Effects on the SF-36 Social Functioning dimension and HADS-D present at 6 months persisted for up to 12 months. Generally, the longer the time since the FM diagnosis, the better was a patient's mood. : The FIBROCARE Program effectively improves all the studied health outcomes except patient mood, since anxiety symptoms persist. The program should reinforce patient psychological support overall, focusing particularly on the years initially after diagnosis.
多成分非药物疗法是纤维肌痛(FM)的首选一线治疗方法,但在初级保健环境中人们对其了解甚少。我们的研究评估了纤维肌痛关爱计划(FIBROCARE Program)在改善纤维肌痛患者生活质量、功能影响、情绪和疼痛方面的有效性。
我们进行了一项实用的随机对照试验,对研究组中接受治疗的患者和专业人员均未设盲。我们将一组接受基于健康教育、体育锻炼和认知行为疗法的非药物多成分团体治疗(MT)的患者与另一组接受常规临床护理的患者进行了比较。MT组在西班牙加泰罗尼亚的初级保健环境中接受了连续12周每周一次的治疗。两组在MT组疗程结束时、疗程结束后6个月和12个月使用简短健康调查问卷(SF - 36)v2、医院焦虑抑郁量表(HADS - A和HADS - D)、视觉模拟量表和修订的纤维肌痛影响问卷进行随访(ClinicalTrials.gov:NCT04049006)。
MT组在疼痛强度、功能影响、身体健康、疲劳以及影响日常活动的情绪问题方面的改善持续了12个月。SF - 36心理健康维度和HADS - A子量表所测量的益处在6个月后消失。对SF - 36社会功能维度和6个月时出现的HADS - D的影响持续了12个月。一般来说,纤维肌痛诊断后的时间越长,患者的情绪越好。
纤维肌痛关爱计划有效地改善了所有研究的健康结局,但患者情绪除外,因为焦虑症状持续存在。该计划应全面加强对患者的心理支持,尤其关注诊断后的最初几年。