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Triantafyllias K, Balaklytska V, Sauer C, Dreher M, Schwarting A. [Effects of a multimodal inpatient treatment for patients with fibromyalgia syndrome at the Rhineland-Palatinate Acute Rheumatology Center]. Z Rheumatol 2024:10.1007/s00393-024-01568-x. [PMID: 39292267 DOI: 10.1007/s00393-024-01568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 09/20/2024]
Abstract
INTRODUCTION Fibromyalgia syndrome (FMS) is a complex condition that is often refractory to therapy and is associated with impaired quality of life. In some studies, multimodal rheumatological treatment has been shown to be an effective therapy option for patients with systemic-inflammatory and degenerative rheumatic diseases. However, the effects of this therapeutic approach have not been sufficiently investigated in patients with FMS. Therefore, the aim of this study was to examine the effect of a concise 9‑ to 10-day inpatient multimodal fibromyalgia treatment (MFT) using patient-reported outcomes in a German cohort. METHODS The effects of MFT were assessed using visual analog scales (VAS) for pain (P) and subjective disease activity (DA), questionnaires measuring everyday functional capacity (Health Assessment Questionnaire [HAQ], Funktions-Fragebogen-Hannover [FFbH, Hannover Functional Ability Questionnaire]), and pharmacotherapy at three time points (Visit 1: beginning of multimodal therapy, Visit 2: end of MFT, and Visit 3: 3 months after Visit 2). RESULTS Sixty-one patients were enrolled in the study at the Rhineland-Palatinate Acute Rheumatology Center. Under MFT, a significant improvement in VAS (P) and VAS (DA) was observed between the start and end of treatment (Visit 2 versus Visit 1: median decrease from 7 to 5, p < 0.001, for both VAS [P] and VAS [DA]). Additionally, comparison of the other two assessment points showed a change in VAS (P) (Visit 3 versus Visit 1: median decrease from 7 to 6, p = 0.041, and Visit 3 versus Visit 2: median increase from 5 to 6, p = 0.004). However, there were no significant differences in FFbH and HAQ parameters among the three visits. Examination of the subgroup of patients whose medication therapy was not intensified during hospitalization also showed significant improvements in VAS (P) and VAS (DA) between the start and end of MFB (Visit 2 versus Visit 1: median decrease from 7 to 4, p < 0.001, for VAS [P] and median decrease from 6.25 to 4, p = 0.002, for VAS [DA]). CONCLUSION These findings indicate a demonstrable benefit to patients of MFT regarding both pain and subjective disease activity. Furthermore, pain relief was even observed 3 months after the end of therapy. This shows the high value of this therapeutic approach to treating patients with FMS.
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Affiliation(s)
- Konstantinos Triantafyllias
- Rheumazentrum Rheinland-Pfalz GmbH, Kaiser-Wilhelm-Str. 9-11, 55543, Bad Kreuznach, Deutschland.
- Schwerpunkt Rheumatologie und klinische Immunologie, I. Med. Klinik und Poliklinik, Johannes Gutenberg Universitätsmedizin-Mainz, Mainz, Deutschland.
| | - Veronika Balaklytska
- Schwerpunkt Rheumatologie und klinische Immunologie, I. Med. Klinik und Poliklinik, Johannes Gutenberg Universitätsmedizin-Mainz, Mainz, Deutschland
| | - Charlotte Sauer
- Innere Medizin, Krankenhaus Sachsenhausen, DGD Kliniken, Frankfurt am Main, Deutschland
| | - Matthias Dreher
- Schwerpunkt Rheumatologie und klinische Immunologie, I. Med. Klinik und Poliklinik, Johannes Gutenberg Universitätsmedizin-Mainz, Mainz, Deutschland
| | - Andreas Schwarting
- Rheumazentrum Rheinland-Pfalz GmbH, Kaiser-Wilhelm-Str. 9-11, 55543, Bad Kreuznach, Deutschland
- Schwerpunkt Rheumatologie und klinische Immunologie, I. Med. Klinik und Poliklinik, Johannes Gutenberg Universitätsmedizin-Mainz, Mainz, Deutschland
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Ozturk GY, Arat NB, Ozdemir AA, Bashan I, Kocyigit BF. The effect of earthquake on fibromyalgia: a comparison of patients on medication and without medication. Rheumatol Int 2024; 44:1345-1351. [PMID: 38722331 PMCID: PMC11178565 DOI: 10.1007/s00296-024-05605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/24/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION / OBJECTIVES Stressful events like earthquakes might worsen the symptoms of fibromyalgia, although the influence of medications on these consequences is yet uncertain. The objective of this study was to examine the influence of an earthquake on the symptoms of fibromyalgia and evaluate the impacts of medications used to treat fibromyalgia on the clinical picture. METHOD Ninety-five fibromyalgia patients were enrolled in a comparative study and divided into two groups: medication and non-medication. Three subcategories of medication groups were established: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and gabapentinoid drugs (GDs). Before and after the earthquake, clinical evaluations were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), and Jenkins Sleep Rating Scale (JSS). Statistical analyses were conducted to compare the scores before and after the earthquake and evaluate the differences between the groups. RESULTS Statistically significant increases were observed in FIQ, HADS-anxiety, HADS-depression, and JSS scores in the medication and non-medication groups before and after the earthquake comparisons (p < 0.05). Non-medication group reported significantly higher post-earthquake changes in FIQ, HADS-anxiety, HADS-depression, and JSS compared to the medication group (p < 0.05). While HADS-anxiety, HADS-depression, and JSS changes after the earthquake differed according to the drug subgroups (p < 0.05), no statistically significant difference was observed in FIQ values (p > 0.05). The highest scores were detected in the GD subgroup. CONCLUSIONS This study highlights the substantial impact of earthquakes on fibromyalgia patients. Medication use may assist in reducing the detrimental effects of stresses like earthquakes on fibromyalgia symptomatology. Future research with larger sample sizes and more extended follow-up periods is needed to explain these findings and optimize treatment regimens for fibromyalgia patients experiencing significant stressors.
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Affiliation(s)
- Gulsah Yasa Ozturk
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Türkiye
| | - Neval Bozok Arat
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Türkiye
| | - Asena Ayca Ozdemir
- Department of Medical Education, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Ibrahim Bashan
- Department of Medical Education, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Türkiye.
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Caballol Angelats R, Aguilar Martín C, Carrasco-Querol N, Abellana R, González Serra G, Gràcia Benaiges D, Sancho Sol MC, Fusté Anguera I, Chavarria Jordana S, Berenguera A, Gonçalves AQ. Usefulness of a Multicomponent Group Intervention Program for Fibromyalgia Patients in Primary Care: A Qualitative Study of Health Professionals. Healthcare (Basel) 2023; 12:17. [PMID: 38200923 PMCID: PMC10779402 DOI: 10.3390/healthcare12010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE To explore the perceptions and experiences of health professionals who participated in a multicomponent program for fibromyalgia (FM) patients based on health education, physical exercise and cognitive-behavioral therapy. METHODS In this qualitative, descriptive study that was based on a pragmatic and utilitarian approach, we conducted two focus groups (FGs) with 12 professionals (nurses and general practitioners) from the primary healthcare system of Spain who had been trained as FM experts. A thematic content analysis was carried out. RESULTS The findings were organized into four key domains, each with explanatory emerging themes. Overall, the professionals positively valued the program for the knowledge gain it offered, its integrated approach, the group effect and other benefits to patients. Work overload and peers' lack of acknowledgement of the program's value were identified as barriers. A reduction in the amount of content in each session, the creation of quality-of-care indicators and the promotion of the new professional role (FM expert) were proposed. CONCLUSIONS The FM experts supported the program and recognized its usefulness. To implement the program within the primary healthcare system, the program needs to be adjusted to accommodate professionals' and patients' reality, and institutional health policies must be improved by providing training on FM to the healthcare community.
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Affiliation(s)
- Rosa Caballol Angelats
- Equip d’Atenció Primària Tortosa Est, Institut Català de la Salut, 43500 Tortosa, Spain
- 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
| | - Carina Aguilar Martín
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Spain
- Unitat d’Avaluació, Direcció d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Spain
| | - Noèlia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Spain
| | - Rosa Abellana
- Departament de Fonaments Clínics, Facultat de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Gemma González Serra
- Servei de Rehabilitació i Medicina Física, Hospital de Tortosa Verge de la Cinta, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
| | - Dolors Gràcia Benaiges
- Servei de Rehabilitació i Medicina Física, Hospital de Tortosa Verge de la Cinta, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
| | - Maria Cinta Sancho Sol
- Unitat d’Expertesa en Síndromes de Sensibilització Central Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Spain
- Centre de Salut Mental d’Adults de Fundació Pere Mata Terres de l’Ebre, 43500 Tortosa, Spain
| | - Immaculada Fusté Anguera
- Equip d’Atenció Primària Tortosa Est, Institut Català de la Salut, 43500 Tortosa, Spain
- Unitat d’Expertesa en Síndromes de Sensibilització Central Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Spain
| | - Susana Chavarria Jordana
- Equip d’Atenció Primària l’Ametlla de Mar—El Perelló, Institut Català de la Salut, 43860 L’Ametlla de Mar, Spain
| | - Anna Berenguera
- Unitat Transversal de Recerca, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Departament d’Infermeria, Universitat de Girona, 17003 Girona, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 28041 Madrid, Spain
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 28041 Madrid, Spain
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