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Effectiveness of group acceptance and commitment therapy for fibromyalgia: A 6-month randomized controlled trial (EFFIGACT study)

APA Citation

Luciano, J. V., Guallar, J. A., Aguado, J., López-del-Hoyo, Y., Olivan, B., Magallón, R., ... & Garcia-Campayo, J. (2014). Effectiveness of group acceptance and commitment therapy for fibromyalgia: A 6-month randomized controlled trial (EFFIGACT study). PAIN, 155(4), 693-702. https://doi.org/10.1016/j.pain.2013.12.029

Publication Topic
ACT: Empirical
Publication Type
Article
RCT
Language
English
Keyword(s)
Acceptance and commitment therapy, Fibromyalgia, Pain acceptance, Psychological therapy
Abstract

In the last decade, there has been burgeoning interest in the effectiveness of third-generation psycholog-ical therapies for managing fibromyalgia (FM) symptoms. The present study examined the effectivenessof acceptance and commitment therapy (ACT) on functional status as well as the role of pain acceptanceas a mediator of treatment outcomes in FM patients. A total of 156 patients with FM were enrolled atprimary health care centers in Zaragoza, Spain. The patients were randomly assigned to a group-basedform of ACT (GACT), recommended pharmacological treatment (RPT; pregabalin + duloxetine), or wait list(WL). The primary end point was functional status (measured with the Fibromyalgia Impact Question-naire, FIQ). Secondary end points included pain catastrophizing, pain acceptance, pain, anxiety, depres-sion, and health-related quality of life. The differences between groups were calculated by linearmixed-effects (intention-to-treat approach) and mediational models through path analyses. Overall,GACT was statistically superior to both RPT and WL immediately after treatment, and improvementswere maintained at 6 months with medium effect sizes in most cases. Immediately after treatment,the number needed to treat for 20% improvement compared to RPT was 2 (95% confidence interval1.2–2.0), for 50% improvement 46, and for achieving a status of no worse than mild impaired function(FIQ total score <39) also 46. Unexpectedly, 4 of the 5 tested path analyses did not show a mediationeffect. Changes in pain acceptance only mediated the relationship between study condition andhealth-related quality of life. These findings are discussed in relation to previous psychological researchon FM treatment.