Summer 2020 (Volume 30, Number 2)
A Multi-disciplinary, Community-based
Group Intervention for Individuals
with Fibromyalgia: A Pilot Randomized
Controlled Trial
By Michelle Teo, MD, FRCPC
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When I started my career as a community rheumatologist,
I did not see how I could integrate
research into my clinical practice. Research requires
expertise in a skill set that many of us lack, such as
grant writing, ethics applications, statistics; the list goes
on. How can the average community rheumatologist expect
to be competent in these areas when research is considered
an “extra” that we do at the side of our desks in between
seeing patients?
If you are a community rheumatologist and see an opportunity
to make a positive change through research, you
can be successful in obtaining a Canadian Initiative for
Outcomes in Rheumatology Care (CIORA) grant. By collaborating
with an academic researcher, you create a partnership
that allows you to focus your time and energy on your
strengths, providing clinical care to patients.
Our team was successful in obtaining a two-year CIORA
grant in 2017 for “A Multi-disciplinary, Community-based
Group Intervention for Individuals with Fibromyalgia: A
Pilot Randomized Controlled Trial.” Rheumatologists in
underserved communities, such as myself, are frequently
unable to see these patients because of our long waitlists.
But it does not mean that patients who have fibromyalgia
do not deserve appropriate care. Furthermore, given the
multitude of health, psychological and societal factors that
contribute to fibromyalgia, it is naïve to believe that a rheumatologist
can provide the full breadth of treatment or that
a patient can access appropriate and integrated resources
on his/her own. We developed a 10-week group-based interprofessional
integrated care model for patients with a
diagnosis of fibromyalgia. The goal was to equip patients
with sustainable and effective disease self-management
tools. Health care professionals involved included: a kinesiologist,
physiotherapist, mental health therapist, dietitian,
social worker and rheumatologist. The study group met
twice a week for 60 minutes of exercise and weekly for 60-
90 minutes of group education. The results of the study
revealed improvements to patient perceived quality of care,
daily function and attitudes towards pain. The next step
of this work is to show how health care utilization changes
when fibromyalgia patients have access to such a program.
Patients living with pain deserve opportunities to empower
themselves with knowledge of mind-body awareness
and self-care. This study is an example of how successful
this approach can be in a limited patient population. I
also hope it encourages other community rheumatologists
to consider collaborating with researchers to improve the
lives of our patients.
Michelle M. Teo, MD, FRCPC
Rheumatologist,
Penticton Regional Hospital
Penticton, British Columbia
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