title: Fibromyalgia Symptom Reduction by Online Behavioral Self-monitoring, Longitudinal Single Subject Analysis and Automated Delivery of Individualized Guidance.
abstract: BACKGROUND
  Fibromyalgia (FM) is a complex chronic pain condition that is difficult to treat. The prevailing approach is an integration of pharmacological, psycho-educational, and behavioral strategies. Information technology offers great potential for FM sufferers to systemically monitor symptoms as well as potential impacts of various management strategies.
  
  
  OBJECTIVE
  This study aimed to evaluate effects of a web-based, self-monitoring and symptom management system (SMARTLog) that analyzes personal self-monitoring data and delivers data-based feedback over time.
  
  
  METHODS
  Subjects were self-referred, anonymous, and recruited via publicity on FM advocacy websites. Standardized instruments assessed health status, self-efficacy, and locus of control at baseline and monthly during participation. Subjects were encouraged to complete the SMARTLog several times weekly. Within-subject, univariate, and multivariate analyses were used to derive classification trees for each user associating specific behavior variables with symptom levels over time.
  
  
  RESULTS
  Moderate use (3 times weekly x 3 months) increased likelihood of clinically significant improvements in pain, memory, gastrointestinal problems, depression, fatigue, and concentration; heavy use (4.5 times weekly x five months) produced the above plus improvement in stiffness and sleep difficulties.
  
  
  CONCLUSIONS
  Individualized, web-based behavioral self-monitoring with personally-tailored feedback can enable FM sufferers to significantly reduce symptom levels over time.
authors.affiliation: Collinge and Associates, Eugene, OR, USA.
authors.forename: William
authors.initials: W
authors.lastname: Collinge
authors.forename: Paul
authors.initials: P
authors.lastname: Yarnold
authors.forename: Robert
authors.initials: R
authors.lastname: Soltysik
keywords: Behavioral medicine; Chronic fatigue syndrome; Fibromyalgia; Self-management; Self-monitoring; Single-subject analysis; Symptom reduction; internet