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Efficacy of a multidisciplinary fibromyalgia treatment adapted for women with low educational levels: A randomized controlled trial
Author(s) -
Castel Antoni,
Fontova Ramon,
Montull Salvador,
Periñán Rocío,
Poveda Maria José,
Miralles Iris,
CascónPereira Rosalia,
Hernández Pilar,
Aragonés Natalia,
Salvat Isabel,
Castro Sonia,
Monterde Sonia,
Padrol Anna,
Sala José,
Añez Cristóbal,
Rull Maria
Publication year - 2013
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.21818
Subject(s) - medicine , fibromyalgia , multidisciplinary approach , physical therapy , randomized controlled trial , rheumatology , distress , clinical psychology , social science , sociology
Abstract Objective Multidisciplinary treatments of fibromyalgia (FM) have demonstrated efficacy. Nevertheless, they have been criticized for not maintaining their benefits and for not being studied for specific populations. Our objectives were to determine the efficacy of a multidisciplinary treatment for FM adapted for patients with low educational levels and to determine the maintenance of its therapeutic benefits during a long‐term followup period. Methods Inclusion criteria consisted of female sex, a diagnosis of FM (using American College of Rheumatology criteria), age between 18 and 60 years, and between 3 and 8 years of schooling. Patients were randomly assigned to 1 of the 2 treatment conditions: conventional pharmacologic treatment or multidisciplinary treatment. Outcome measures were functionality, sleep disturbances, pain intensity, catastrophizing, and psychological distress. Analysis was by intent‐to‐treat and missing data were replaced following the baseline observation carried forward method. Results One hundred fifty‐five participants were recruited. No statistically significant differences regarding pretreatment measures were found between the 2 experimental groups. Overall statistics comparison showed a significant difference between the 2 groups in all of the variables studied ( P < 0.0001). Mixed linear model analysis demonstrated the superiority of the multidisciplinary treatment in all of the studied variables at posttreatment. The differences were maintained at 12‐month followup in sleep disturbances ( P < 0.0001), catastrophizing ( P < 0.0001), and psychological distress ( P < 0.01). Conclusion Multidisciplinary treatment adapted for individuals with low educational levels is effective in reducing key symptoms of FM. Some improvements were maintained 1 year after completing the multidisciplinary treatment.