RT Journal Article
SR Electronic
T1 Predictors of Adherence to an Integrated Multimodal Program for Fibromyalgia
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2255
OP 2264
DO 10.3899/jrheum.071262
VO 35
IS 11
A1 PATRICIA L. DOBKIN
A1 RALUCA IONESCU-ITTU
A1 MICHAL ABRAHAMOWICZ
A1 MURRAY BARON
A1 SASHA BERNATSKY
A1 AURELIO SITA
YR 2008
UL http://www.jrheum.org/content/35/11/2255.abstract
AB Objective To describe treatment adherence to a multimodal integrated program for patients with fibromyalgia (FM), identify predictors of adherence to treatment recommendations, and examine the relationship between adherence and patient outcomes. Methods Sixty-three patients with FM were followed while participating in a 3-month outpatient program including physiotherapy, occupational therapy, nursing, and cognitive-behavior therapy. Patients completed a battery of psychosocial questionnaires pre- and post-treatment. At the end of each month of the treatment, patients completed 2 adherence questionnaires (for general and specific adherence) and 1 questionnaire about barriers to adherence to treatment. Generalized estimating equations extension of multivariable linear regression analyses for repeated measures examined predictors of general and specific adherence. Conventional linear regression analyses examined the relationships of general adherence with post-treatment FM disability and pain intensity. Results In general, adherence to treatment recommendations was good (mean general adherence score of 62 points, on a 0 to 100 scale), with no significant changes in mean level of general or specific adherence over the 3-month period. The main predictor for both general and specific adherence was barriers to adherence to treatment. Increased general adherence was significantly associated with lower pain at post-treatment. Conclusion The items described in the questionnaire for barriers to treatment are the main problem when it comes to adhering to a multimodal treatment program for FM. Healthcare professionals are advised to discuss these barriers directly with patients and assist in overcoming them.