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Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: a randomised controlled trial

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Abstract

This study aimed to examine the effectiveness of a multidisciplinary intervention with aftercare (MD) compared to aerobic exercise (AE) and usual care (UC) in recently diagnosed patients with fibromyalgia (FM). In a Zelen-like design, eligible patients from the outpatient rheumatology clinics of three medical centres in the South of the Netherlands were consecutively recruited and pre-randomised to MD (n = 108), AE (n = 47) or UC (n = 48). MD consisted of a 12-week course of sociotherapy, physiotherapy, psychotherapy and creative arts therapy (three half days per week), followed by five aftercare meetings in 9 months. AE was given twice a week in a 12-week course. UC varied but incorporated at least education and lifestyle advice. Primary outcomes were health-related quality of life (HR-Qol), participation and health care utilisation. Secondary outcome was the Fibromyalgia Impact Questionnaire (FIQ). Total follow-up duration of the study was 21–24 months. As willingness to participate in AE was limited, this group has been analysed but interpretation of the data is considered arguable. Within the MD group, a statistically significantly improved HR-Qol and a statistically significant reduction in number of hours sick leave, number of contacts with general practitioners and number of contacts with medical specialists was found. Moreover, statistically significant improvements were found on the FIQ, which increased after the intervention. However, no statistically significant between-group differences were found at the endpoint of the study. MD seemed to yield positive effects, but firm conclusions with regard to effectiveness cannot be formulated due to small between-group differences and limitations of the study.

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Acknowledgments

The study was supported by Maastricht University Medical Centre and by Care Renewal Grants of medical insurance companies in the region.

Disclosures

None.

Author information

Authors and Affiliations

  1. Department of Integrated Care, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    Yvonne van Eijk-Hustings, Mariëlle Kroese & Monique Bessems-Beks

  2. Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands

    Frans Tan

  3. Division of Rheumatology, Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands

    Annelies Boonen

  4. CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands

    Mariëlle Kroese & Annelies Boonen

  5. Division of Rheumatology, Department of Medicine, Academic Medical Centre Amsterdam University/Atrium Medical Centre, Heerlen, The Netherlands

    Robert Landewé

Authors
  1. Yvonne van Eijk-Hustings
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  2. Mariëlle Kroese
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  3. Frans Tan
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  4. Annelies Boonen
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  5. Monique Bessems-Beks
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  6. Robert Landewé
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Corresponding author

Correspondence to Yvonne van Eijk-Hustings.

Additional information

Trial registration: ISRCTN32542621.

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van Eijk-Hustings, Y., Kroese, M., Tan, F. et al. Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: a randomised controlled trial. Clin Rheumatol 32, 199–209 (2013). https://doi.org/10.1007/s10067-012-2100-7

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  • DOI: https://doi.org/10.1007/s10067-012-2100-7

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