Efficacy, acceptability and safety of Internet‐delivered psychological therapies for fibromyalgia syndrome: A systematic review and meta‐analysis of randomized controlled trials

Bernardy, Kathrin; Klose, Petra; Welsch, Patrick; Haüser, Winfried

doi:10.1002/ejp.1284

Cited by 49 publications

(37 citation statements)

References 39 publications

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“…Results from Study II was also slightly higher than the between-group effect sizes reported by other studies on fatigue, sleep problems and the risk difference (RD) in attaining ≥50% pain relief (RD 0.27) and a ≥20% improvement of health-related quality of life (RD 0.31) in a recent review and meta-analysis on internet-delivered psychological therapies for FM (≥50% pain relief RD 0.10; ≥20% improvement of health-related quality of life RD 0.22). 133 With the exception of a recent Dutch study, 109 results from Study II are also comparable to previous randomized controlled trials of exposure therapy for other chronic pain conditions (although it should be noted that the primary outcome in Study II differs from previous trials, i.e., by also covering FM symptoms other than pain and painrelated disability). As described previously though, the iExp treatment manual differ from existing exposure protocols for chronic pain.…”

Section: Is Internet-delivered Exposure Therapy Acceptable and Effectsupporting

confidence: 53%

Approach as a key for success: Reduced avoidance behaviour mediates the effect of exposure therapy for fibromyalgia

Hedman-Lagerlöf

Andersson

Hedman‐Lagerlöf

et al. 2019

Behaviour Research and Therapy

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Section: Is Internet-delivered Exposure Therapy Acceptable and Effectsupporting

confidence: 53%

Approach as a key for success: Reduced avoidance behaviour mediates the effect of exposure therapy for fibromyalgia

Hedman-Lagerlöf

Andersson

Hedman‐Lagerlöf

et al. 2019

Behaviour Research and Therapy

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“…Online delivery can make interventions more accessible to patients e.g. in rural areas since logistic barriers such as travel or limited access to trained therapists are eliminated [44]. As reported in S8, Simister et al [42] obtained 100% adherence which might support further development and exploration of online interventions for FM in future research.…”

Section: Discussionmentioning

confidence: 92%

Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses

et al. 2019

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Objectives To analyze health effects of mindfulness- and acceptance-based interventions, including mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT) and acceptance and commitment therapy (ACT). Additionally, we aimed to explore content and delivery components in terms of procedure, instructors, mode, length, fidelity and adherence in the included interventions. Methods We performed a systematic literature search in the databases MEDLINE, PsychINFO, CINAHL, EMBASE, Cochrane Central and AMED from 1990 to January 2019. We included randomized and quasi-randomized controlled trials analyzing health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia compared to no intervention, wait-list control, treatment as usual, or active interventions. MBSR combined with other treatments were included. Predefined outcomes were pain, fatigue, sleep quality, psychological distress, depression, anxiety, mindfulness, health-related quality of life and work ability. The Template for Intervention Description and Replication (TIDieR) checklist and guide was used to explore content and delivery components in the interventions. Meta-analyses were performed, and GRADE was used to assess the certainty in the evidence. Results The search identified 4430 records, of which nine original trials were included. The vast majority of the participants were women. The analyses showed small to moderate effects in favor of mindfulness- and acceptance-based interventions compared to controls in pain (SMD -0.46 [95% CI -0.75, -0.17]), depression (SMD -0.49 [95% CI -0.85, -0.12]), anxiety (SMD -0.37 [95% CI -0.71, -0.02]), mindfulness (SMD -0.40 [-0.69, -0.11]), sleep quality (SMD -0.33 [-0.70, 0.04]) and health-related quality of life (SMD -0.74 [95% CI -2.02, 0.54]) at end of treatment. The effects are uncertain due to individual study limitations, inconsistent results and imprecision. Conclusion Health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia are promising but uncertain. Future trials should consider investigating whether strategies to improve adherence and fidelity of mindfulness- and acceptance-based interventions can improve health outcomes.

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“…A power analysis for the group comparison iSOMA versus WLCG using analysis of covariance (ANCOVA) with baseline scores as covariates, an α error of 0.05 and a power of β=0.80 showed that a sample size of n=128 is required. Considering attrition rates of previous trials, for example, in functional somatic syndromes,97 chronic pain98 or various chronic health conditions99 as well as recent trials in the relevant target group of university students,29 a drop-out rate of 20% is expected for the current trial, resulting in a necessary sample size of n=154 (n=77 per group). The estimated sample size is suitable regarding prevalence rates of the somatoform syndrome45 and somatoform disorders in German university students 46…”

Section: Methodsmentioning

confidence: 99%

Efficacy of a guided internet-based intervention (iSOMA) for somatic symptoms and related distress in university students: study protocol of a randomised controlled trial

Hennemann¹,

Böhme²,

Baumeister

et al. 2018

BMJ Open

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IntroductionPersistent and distressing somatic symptoms are common in younger age cohorts such as university students. However, the majority does not receive adequate psychosocial care. Internet-based and mobile-based interventions may represent low threshold and effective extensions to reduce somatic and associated mental symptom severity. The planned study aims to investigate the feasibility and efficacy of an internet-based intervention in reducing somatic and psychological symptoms in an international population of university students with somatic symptom burden.Methods and analysisThis parallel two-armed randomised controlled trial evaluates an 8-week guided intervention, including web-based consecutive modules based on cognitive behavioural therapy (CBT) principles against a waitlist control group. Guidance will be provided by trained psychologists with weekly written supportive feedback. As part of the ‘Studicare’ project, the present study aims to recruit n=154 university students indicating somatic symptom burden at baseline in German-speaking universities. Self-report assessments will take place at baseline and after intervention completion (8, 16 weeks after randomisation). The primary outcome will be the severity of somatic symptoms and associated mental distress. Secondary outcomes include depression, (health) anxiety, disability, intervention satisfaction and adherence.Ethics and disseminationEthics approval has been granted. Results from this study will be published in peer-reviewed journals and presented at international conferences.Trial registration numberDRKS00014375; Pre-results.

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Efficacy, acceptability and safety of Internet‐delivered psychological therapies for fibromyalgia syndrome: A systematic review and meta‐analysis of randomized controlled trials

Abstract: Internet-delivered cognitive behavioural therapies provided a clinically relevant benefit in reducing negative mood and disability in patients with FMS at the end of treatment if compared to waiting list, treatment as usual and attention controls.

Cited by 49 publications

References 39 publications

Approach as a key for success: Reduced avoidance behaviour mediates the effect of exposure therapy for fibromyalgia

Approach as a key for success: Reduced avoidance behaviour mediates the effect of exposure therapy for fibromyalgia

Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses

Efficacy of a guided internet-based intervention (iSOMA) for somatic symptoms and related distress in university students: study protocol of a randomised controlled trial

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