A Mixed Educational Program for Fibromyalgia Managed by a Nurse: A Retrospective Evaluation

Current guidelines for the treatment of fibromyalgia support a multicomponent approach combining pharmacological and nonpharmacological interventions. The potential effectiveness of a nonpharmacological multicomponent pilot program combining psychosocial education, water-based therapy, and relaxation was assessed.

Participants with fibromyalgia attended 3-to-4-hour weekly sessions for 8 weeks. The sessions were held in groups of eight to nine patients and included physical and educational components. The physical component included a 1-hour balneotherapy followed by a 1-hour relaxation. The educational component included eight 1-to-2-hour sessions with pain specialists, trained nurses, a sleep specialist, a nutritionist, a psychologist, and a psychometrician. The program staff recorded self-reported symptoms at the start (T0), the end (week 8 [W8]), and 6 months after the end (month 6 [M6]) of the program, using the Fibromyalgia Impact Questionnaire (FIQ) and the Hospital Anxiety and Depression Scale (HADS) questionnaire.

Sixty-eight patients (66 females, mean age 49 years) participated in the program and gave informed consent for the analysis. Fifty-six had data available for all questionnaires at all time points (T0, W8, and M6). Patients with a T0 FIQ score of ≥59 had higher mean T0 anxiety and T0 depression scores compared with other patients (anxiety: 15.1 [SD 4.43] vs. 12.2 [SD 2.63], p = .0014; depression: 11.7 [SD 3.68] vs. 10.1 [SD 3.63], p = .049). Compared to T0 values, the anxiety and depression scores significantly decreased at W8 (anxiety T0: 13.7 [SD 3.95] vs. W8 12.3 [SD 4.04], p = .0009; depression T0: 11.0 [SD 3.71] vs. W8: 9.4 [SD 3.81], p = .0019); and the FIQ score significantly decreased at W8 in the group of patients with a T0 FIQ score ≥59 (T0 FIQ 69 [SD 7.82] vs. W8 FIQ 59.9 [SD 9.6], p = .0004).

This pilot analysis suggests that this multicomponent intervention has the potential to alleviate anxiety and depression symptoms and improve the quality of life of patients with fibromyalgia. Further randomized trials should assess the short- and long-term effectiveness of this intervention.