Multidisciplinary Group Intervention for Fibromyalgia: A Study of Psychiatric Symptom and Functional Disability Outcomes

纤维肌痛的多学科团队干预:精神症状和功能障碍结果研究

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Abstract

OBJECTIVE: To assess psychiatric symptoms and functional impairment in patients with fibromyalgia after they participated in a half-day group clinic administered by the rheumatology department at Kaiser Permanente in Colorado. METHODS: Questionnaires were given to 184 patients at the beginning of the group clinic and by telephone interview 11 to 23 months after completion of the group clinic. Questionnaires assessed demographics, psychiatric symptoms, functional impairment, work disability, and history of physical or emotional trauma and physical, emotional, or sexual abuse. RESULTS: Questionnaire responses indicated that patients had statistically significantly less anxiety (p = 0.002), depression (p < 0.001), panic (p = 0.029), pain (p = 0.003), restless sleep (p < 0.001), stiffness (p < 0.001), nervousness/tenseness (p < 0.001) after attending the group clinic. Number of missed work days significantly decreased (p = 0.003), and patients’ ability to do their jobs was also significantly improved (p < 0.001). However, neither interference in five major life domains nor instrumental activities of daily living improved. Number of visits to primary and specialty care also decreased significantly (p < 0.005). CONCLUSIONS: In fibromyalgia patients referred to a rheumatology department, a multidisciplinary group clinic intervention may effectively improve outcomes in both mental health and functional status. This group clinic model may also reduce medical utilization and associated costs.

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