3 research outputs found
Efectividad de la educaci贸n en neurociencia del dolor frente a las terapias habituales para el abordaje de la fibromialgia. Intervenci贸n grupal estructurada en atenci贸n primaria.
110 p.Ha aumentado el inter茅s en la Educaci贸n en Neurociencia del Dolor (PNE) como enfoque terap茅utico para el manejo de la fibromialgia (FM). Objetivos: se propone una intervenci贸n de PNE que a帽ade la hip贸tesis de error evaluativo aprendido para conocer si es m谩s efectiva que el tratamiento habitual (TH) para reducir el impacto de la FM. M茅todos: se realiz贸 un ensayo multic茅ntrico, aleatorizado, abierto y controlado para evaluar la efectividad de una intervenci贸n grupal estructurada, en Atenci贸n Primaria, basada en PNE, en pacientes con FM. Se incluyeron 139 pacientes, asignados al azar al grupo intervenci贸n (7 sesiones de PNE) o al grupo control (TH solamente). El resultado primario fue la mejora del estado funcional y el dolor, medidos con el Cuestionario de Impacto de la FM (FIQ), y los resultados secundarios fueron la reducci贸n del impacto del dolor y otros s铆ntomas (catastrofizaci贸n, ansiedad y depresi贸n). Resultados: al cabo de un a帽o, las mejoras en las puntuaciones del FIQ fueron mayores en el grupo intervenci贸n, con un tama帽o de efecto moderado o alto, con disminuciones en el FIQ 驴20% en el 69.1% de los pacientes (20.9% en el grupo control), 驴50% en el 39.7% (4.5% en el grupo control), y con FIQ驴39 puntos en 52.9% (13.4% en grupo control). Conclusiones: se obtuvo una mejora en la calidad de vida y en el control de los s铆ntomas de pacientes con FM al agregar una intervenci贸n de PNE, igualando o superando los resultados previamente publicados. Se plantea como una nueva alternativa para abordar el manejo de s铆ntomas persistentes sin da帽o tisular correlacionado, y aporta una hip贸tesis etiol贸gica
Effectiveness of a Structured Group Intervention Based on Pain Neuroscience Education for Patients with Fibromyalgia in Primary Care: a Multicentre Randomized Open-Label Controlled Trial
Background There has been increased interest in pain neuroscience education (PNE) as a therapeutic approach for the management of fibromyalgia (FM).
Methods A multicentre randomized, open-label, controlled trial was conducted to assess the effectiveness of a structured group intervention based on PNE in patients with FM. A total of 139 patients were included in the study and randomized to the intervention group (7 group sessions of education in neurobiology of pain) or to the control group (treatment as usual only). The primary outcome was the improvement of functional status and pain measured with the Fibromyalgia Impact Questionnaire (FIQ), and secondary outcomes were the reduction in the impact of pain and other symptoms (catastrophizing, anxiety and depression) and number of patients reaching no worse than moderate functional impairment (FIQ score <39). Differences between groups were calculated by linear mixed-effects (intention-to-treat approach) and mediational models through path analyses.
Results At 1 year, improvements in FIQ scores were higher in the intervention group with moderate or high effect size, and decreases of >= 20% in 69.1% of patients (20.9% in the control group) and of >= 50% in 39.7% (4.5% in the control group). Also, 52.9% of patients had a FIQ <39 points (13.4% in the control group).
Conclusions In this sample of patients with FM, the improvement in quality of life and control of symptoms obtained by adding a PNE intervention showed promising results, equalling or surpassing previously reported outcomes.
Significance A structured group intervention based on pain neuroscience education for 1 year in patients with fibromyalgia was associated with significant amelioration of the impact of the disease on scores of the Fibromyalgia Impact Questionnaire, the Health Assessment Questionnaire, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale and the Polysymptomatic Distress Scale as compared with only treatment as usual. These findings are clinically relevant considering the challenges posed by fibromyalgia to clinicians and patients alike.Partial reduction of routine work tasks of the principal investigator, MJ Barrenengoa-Cuadra, was supported by a grant from OSI Bilbao Basurto Osakidetza, Basque country, Spain (the grant was paid to the Health Service to substitute MJ Barrenengoa-Cuadra while research work)
Fibromialgia: adversidad desde el sistema sanitario
Los autores declaran no haber recibido financiaci贸n alguna para la elaboraci贸n y publicaci贸n del trabajo