Predictors of disability and pain six months after the end of treatment for fibromyalgia.
OBJECTIVE
The goal of this study was to identify factors associated with decreased disability and lower pain scores 6 months after a multimodal treatment program for fibromyalgia (FM).


METHODS
Forty-six patients with FM were assessed after having participated in a 3-month outpatient program integrating physiotherapy, occupational therapy, nursing, and cognitive-behavior therapy. A physician examined the patients before treatment and patients who completed a battery of psychosocial questionnaires at baseline, during treatment, at the end of treatment, and 3 and 6 months after the end of treatment. Two separate multivariable linear regression models were built to identify predictors of improvements in disability and pain.


RESULTS
Two predictors for improvement in disability were found: an increase in self-efficacy for pain during treatment and better general adherence during treatment. Similarly, one predictor for improvement in pain intensity was found: an increase in self-efficacy for pain during treatment.


CONCLUSIONS
Self-efficacy and adherence are 2 modifiable factors that influence disability and pain intensity in FM. These psychosocial factors need to be addressed in FM treatment programs to assist patients in maintaining posttreatment improvements.
Dobkin
Patricia L
PL
Department of Medicine, McGill University Health Centre, 687 Pine Avenue West, Montreal, Quebec, Canada. patricia.dobkin@mcgill.ca
Liu
Aihua
A
Abrahamowicz
Michal
M
Ionescu-Ittu
Raluca
R
Bernatsky
Sasha
S
Goldberger
Arielle
A
Baron
Murray
M
D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010146:Pain / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods; D010349:Patient Compliance / Q000523:psychology; D011237:Predictive Value of Tests; D012648:Self Care; D013997:Time Factors; D016896:Treatment Outcome