Therapeutic Patient Education for Fibromyalgia during Spa Therapy: The FiETT Randomized Controlled Trial

Abstract

Spa therapy is known to improve quality of life and diminish pain. We assessed the efficacy (Fibromyalgia Impact Questionnaire-FIQ) and safety at 6 months of a fibromyalgia-specific therapeutic patient education (TPE) program added to fibromyalgia-specific standardized spa therapy (SST), compared to SST alone, in a controlled randomized trial. We enrolled 157 patients, mostly women, attending spa centers in Southwest France in 2015–2016, and randomized them to SST + TPE (79) or SST (78). The intention-to-treat with “missing as failure” analysis showed a tendency toward a higher, though non-significant, benefit with TPE than without for FIQ (−9 vs. −3; p = 0.053) or pain intensity (−0.9 vs. −1.1; p = 0.58). In addition, pain relief (+3.2 vs. +4.3; p = 0.03) and fatigue (−1.6 vs. −3.7; p = 0.02) were significantly improved, and 87% patients in the SST + TPE arm still regularly practiced the physical exercises taught to them at 6 months. We suspect significant and lasting improvement from spa therapy, as well as our already well-informed and well-managed participants, to have prevented the demonstration of a significant benefit of TPE on FIQ.

Are OMERACT recommendations followed in clinical trials on fibromyalgia? A systematic review of patient-reported outcomes and their measures

“…In summary, only 8.6% (9 studies) of the studies covered all mandatory domains as recommended by OMERACT [ 26 , 31 , 41 , 42 , 75 , 76 , 87 , 112 , 130 ] and only 6.7% (7 studies) covered all mandatory and optional domains [ 26 , 31 , 41 , 42 , 76 , 112 , 130 ]. Remarkably, although the OMERACT recommendations have been available since 2009 [ 5 ], only eight studies referred to those recommendations in the methods section or in the discussion [ 30 , 56 , 73 , 79 , 80 , 113 , 125 , 126 ]. Seven studies cited the OMERACT core set because they explicitly conformed to their recommendations [ 30 , 56 , 73 , 80 , 113 , 125 , 126 ].…”

“…Remarkably, although the OMERACT recommendations have been available since 2009 [ 5 ], only eight studies referred to those recommendations in the methods section or in the discussion [ 30 , 56 , 73 , 79 , 80 , 113 , 125 , 126 ]. Seven studies cited the OMERACT core set because they explicitly conformed to their recommendations [ 30 , 56 , 73 , 80 , 113 , 125 , 126 ].…”

The Potential Role of Spa Therapy in Managing Frailty in Rheumatic Patients: A Scoping Review

“…In a randomized controlled trial, an FM-specific therapeutic education program added to spa therapy showed benefits in quality of life and pain intensity compared to standard therapy alone [ 139 ]. At 6 months, the physical exercises taught during the education program were still practiced regularly by 87% of patients [ 139 ].…”

“…In a randomized controlled trial, an FM-specific therapeutic education program added to spa therapy showed benefits in quality of life and pain intensity compared to standard therapy alone [ 139 ]. At 6 months, the physical exercises taught during the education program were still practiced regularly by 87% of patients [ 139 ]. Furthermore, the combination of low-dose radon treatment, physical exercise, massages, mud therapy, prevention strategies, education strategies and healthy nutrition demonstrated some beneficial effects in FM patients [ 124 ].…”

Social Networks in French Balneotherapy: A Focus on Spa Doctors

“…Several large randomized controlled trials have demonstrated the benefit of balneotherapy in several conditions: musculoskeletal conditions [2][3][4][5][6][7], venous conditions [8], stress-related disorders [9], overweight and metabolic syndrome [10][11][12], post-breast cancer [13][14][15] and neurodegenerative disorders [16]. Papers have also been published on "therapeutic patient education" for fibromyalgia [17], venous insufficiency [18], chronic low back pain [19], physical activity [20,21] or psychotropic withdrawal [22]. The medical literature also provides scientific evidence of resource-saving and less medication [9,23,24] and suggests fewer hospital stays [16,25] thanks to spa therapy.…”