María Jesús Barrenengoa-Cuadra1, Luis Ángel Angón-Puras2, José Ignacio Moscosio-Cuevas3, Jesús González-Lama4, Marian Fernández-Luco5, Rafael Gracia-Ballarín6. 1. Centro de Salud Sáenz de Buruaga (Osakidetza), Bilbao, Vizcaya, España; Grupo de Trabajo de Fibromialgia, Migraña y Dolor crónico de Osatzen, Sociedad Vasca de MFyC, Bilbao, Vizcaya, España. 2. Grupo de Trabajo de Fibromialgia, Migraña y Dolor crónico de Osatzen, Sociedad Vasca de MFyC, Bilbao, Vizcaya, España; Centro de salud Las Arenas (Osakidetza), Getxo, Vizcaya, España. 3. Centro de Salud Fuensanta, Distrito de AP Córdoba-Guadalquivir (Servicio Andaluz de Salud), Córdoba, España; Grupo Programa Comunicación y Salud -GPCyS- (semFYC), Barcelona, España. 4. Grupo Programa Comunicación y Salud -GPCyS- (semFYC), Barcelona, España; Unidad de Gestión Clínica de Cabra, Centro de salud Matrona Antonia Mesa Fernández, Área de Gestión Sanitaria Sur de Córdoba (Servicio Andaluz de Salud), Cabra, Córdoba, España; Programa de Actividades Preventivas y de Promoción de la Salud -PAPPS- (semFYC), Barcelona, España; Grupo de investigación Clínico-Epidemiológica en Atención Primaria (GICEAP), Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, España. Electronic address: jegonla@telefonica.net. 5. Grupo de Trabajo de Fibromialgia, Migraña y Dolor crónico de Osatzen, Sociedad Vasca de MFyC, Bilbao, Vizcaya, España; Centro de Salud de Begoña (Osakidetza), Bilbao, Vizcaya, España. 6. Grupo de Trabajo de Fibromialgia, Migraña y Dolor crónico de Osatzen, Sociedad Vasca de MFyC, Bilbao, Vizcaya, España; Centro de Salud de Amurrio (Osakidetza), Amurrio, Álava, España.
Abstract
OBJECTIVE: To evaluate the effectiveness of a group intervention in Primary Care in patients with fibromyalgia (FM) based on pain neuroscience education (PNE). DESIGN: Pre-post study. LOCATION: Urban Primary Health Centre in Bilbao. PARTICIPANTS: Patients with FM (2010 American College of Rheumatology Diagnostic Criteria for fibromyalgia), ≥18 years. INTERVENTION: 5 weekly sessions (2hours each), and a reminder session one month later. MAIN MEASUREMENTS: Compliance with FM criteria, assessed using the WPI (Widespread Pain Index, number of pain areas) and the SS (severity of symptoms) questionnaires. An assessment was also made on the impact of FM on functional capacity (FIQ:≥20% and ≥50% reduction in the FIQ total score from baseline to after treatment, and proportion of patients with FIQ<39 at the end of the study). Assessments were made at baseline, one month following the 5th session, and during the 6- and 12-month follow-up. RESULTS: All the study evaluations were completed by 85/98 patients. A statistically significant improvement was observed in the 3 studied categories (WPI, SS, and FIQ) since the first visit, and was maintained until the final visit (12 months later). A total of 45 patients (53%, 95% CI: 42%-63%), more than those at baseline, scored FIQ<39 (no worse than mild functional impairment). One month following the 5th session there were 44 patients (52%, 95% CI: 41%-62%) that no longer met FM criteria and, at the end of follow-up, there were 56 patients (66%, 95% CI: 55%-75%). CONCLUSIONS: An intervention based on PNE has shown to be feasible in Primary Care, with results in the upper range of those published with other treatments for FM.
OBJECTIVE: To evaluate the effectiveness of a group intervention in Primary Care in patients with fibromyalgia (FM) based on pain neuroscience education (PNE). DESIGN: Pre-post study. LOCATION: Urban Primary Health Centre in Bilbao. PARTICIPANTS: Patients with FM (2010 American College of Rheumatology Diagnostic Criteria for fibromyalgia), ≥18 years. INTERVENTION: 5 weekly sessions (2hours each), and a reminder session one month later. MAIN MEASUREMENTS: Compliance with FM criteria, assessed using the WPI (Widespread Pain Index, number of pain areas) and the SS (severity of symptoms) questionnaires. An assessment was also made on the impact of FM on functional capacity (FIQ:≥20% and ≥50% reduction in the FIQ total score from baseline to after treatment, and proportion of patients with FIQ<39 at the end of the study). Assessments were made at baseline, one month following the 5th session, and during the 6- and 12-month follow-up. RESULTS: All the study evaluations were completed by 85/98 patients. A statistically significant improvement was observed in the 3 studied categories (WPI, SS, and FIQ) since the first visit, and was maintained until the final visit (12 months later). A total of 45 patients (53%, 95% CI: 42%-63%), more than those at baseline, scored FIQ<39 (no worse than mild functional impairment). One month following the 5th session there were 44 patients (52%, 95% CI: 41%-62%) that no longer met FM criteria and, at the end of follow-up, there were 56 patients (66%, 95% CI: 55%-75%). CONCLUSIONS: An intervention based on PNE has shown to be feasible in Primary Care, with results in the upper range of those published with other treatments for FM.
Keywords:
Central nervous system sensitisation; Chronic pain; Dolor crónico; Educación del paciente; Fibromialgia; Fibromyalgia; Neurociencia; Neuroscience; Patient education; Sensibilización del sistema nervioso central
Authors: Paula B Areso-Bóveda; Julia Mambrillas-Varela; Bárbara García-Gómez; José Ignacio Moscosio-Cuevas; Jesús González-Lama; Eva Arnaiz-Rodríguez; María Begoña Arroyo Del Barco; Pilar San Teodoro-Blanco Journal: BMC Musculoskelet Disord Date: 2022-04-04 Impact factor: 2.362