Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry
Objective Relationships between patient education and long-term clinical outcomes are complex. This study used real-world data to evaluate the impact of improved pain knowledge on clinical outcomes in fibromyalgia patients.Methods Prospectively collected registry-based observational data were analys...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/11/2/e005576.full |
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| Summary: | Objective Relationships between patient education and long-term clinical outcomes are complex. This study used real-world data to evaluate the impact of improved pain knowledge on clinical outcomes in fibromyalgia patients.Methods Prospectively collected registry-based observational data were analysed to emulate a randomised clinical trial. Study participants were diagnosed with fibromyalgia, had a high need to learn about pain (Numeric Rating Scale >7), had attended a 2-day therapeutic educational programme and re-rated their learning needs after the programme. A good educational outcome was defined as a re-rating score <5, while a poor outcome was ≥5. The primary endpoint at 9 months was the overall impact of fibromyalgia, measured by the Fibromyalgia Impact Questionnaire Revised (FIQR) impact subscale.Results The eligible cohort comprised 450 participants. The intention-to-treat from population included 121 participants (26.9%) with a good educational outcome and 329 participants (73.1%) with a poor educational outcome (comparator group). Missing outcome data were handled implicitly by the repeated measures linear mixed models, assuming data are missing at random.At the 9-month endpoint, the fully adjusted FIQR impact subscale score was lower in the good educational outcome group (8.0 (95% CI 7.3 to 8.7)) compared with the poor educational outcome group (9.6 (95% CI 9.0 to 10.2)), indicating a better clinical outcome for those with a good educational outcome. The model-estimated between-group difference was −1.6 (95% CI −2.5 to −0.7; p=0.0006) FIQR impact subscale units.Conclusions This study suggests that achieving pain educational learning objectives leads to better clinical outcomes in fibromyalgia patients, supporting the integration of pain education into patient programmes. |
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| ISSN: | 2056-5933 |