People with fibromyalgia enrolled in a new patient education program that emphasizes disease self-management were found to have better disease knowledge compared to patients in the usual care program, at least in the short to medium term.
The study, “Evaluation of a self-management patient education programme for fibromyalgia—results of a cluster-RCT in inpatient rehabilitation,” was published in the journal Health Education Research.
People with fibromyalgia syndrome (FMS) have chronic widespread pain and other symptoms, including fatigue, disturbed sleep, cognitive issues, and depression.
FMS guidelines recommend multidisciplinary treatment, including medical treatment, psychological therapy, exercise therapy, disease education, and social counseling. Psychological treatments and disease education in particular have shown small but robust beneficial effects.
German researchers developed a self-management patient education program led by physicians, psychologists, and physiotherapists. It covered topics including diagnosis and treatment of FMS, coping strategies for pain and stress, and incorporation of physical activity into everyday life. This program was focused specifically on self-management of the disease.
Researchers set out to assess the effectiveness of this program on its ability to promote disease understanding and self-management competencies (patients’ ability to manage their own condition) compared to the usual care education (control group).
A total of 583 patients were enrolled in a clinical trial (DRKS00008782) and divided into intervention and control groups. Subjects completed questionnaires at admission, discharge and after six and 12 months.
The intervention group, which received the self-management patient education program, underwent six 90-minute sessions plus one optional preparation session.
The control group received usual standard care, which included information about FMS and coping with pain. However, in contrast to the self-management patient education program, usual care education did not include recent evidence on FMS and was less oriented to self-management.
Results from the study indicated that, at discharge, there was a statistically significant difference between the two groups regarding disease and treatment-specific knowledge. Participants in the intervention group showed better knowledge compared to patients in the control group.
Furthermore, there was a smaller, but still statistically significant, effect on secondary outcomes — including subjective knowledge, pain-related control, self-monitoring and insight, communication about disease, incorporation of physical activity, and treatment satisfaction — between the two groups at discharge. The intervention group scored better across all these variables.
The authors wrote, “At discharge, [intervention group] participants rated their knowledge higher and were more satisfied with their knowledge.”
However, only the beneficial effect on knowledge persisted over the course of six and 12 months.
Additionally, contrary to what the authors had hypothesized, there were no differences in self-management competencies in the intervention group at six and 12 months.
Interestingly, there was an unexpected statistically significant difference between the groups in regard to anxiety at discharge, with the control group having less compared to the intervention group.
Therefore, the authors concluded, “our primary hypothesis was only partly confirmed; participants of the treatment group had a greater improvement in knowledge in the short term compared with the [control group], but not in self-management competencies in the medium term.”
The authors also emphasized that superior effectiveness of the new program was not established in the long term; thus, further studies are needed.
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