Long-term follow-up of fibromyalgia patients who completed a structured treatment program versus patients in routine treatment

Objective: To determine whether patients with fibromyalgia [FMS], treated in a tertiary care setting, got worse over time, remained the same, or got better. Methods: Validated self-report questionnaires and checklists were sent at two-year intervals to patients who were screened for entry into a six-month FMS treatment program. Patients were divided into subgroups based on whether they finished the program or did not enter or finish. They were followed for up to nine years. Results: The subgroup that finished the six-month program had lower Fibromyalgia Impact Questionnaire and Beck Depression Inventory and higher Quality of Life Scale scores over time than the subgroup that did not enter the program or finish. The Fibromyalgia Impact Questionnaire scores of program finishers were significantly lower at three to four years [P = .031] and seven to nine years [P = .001]. Beck Depression Inventory scores were significantly lower at three to four years [P = .047]. The Quality of Life Scale scores were not significantly different at any measurement. Over the survey period, a majority of the total group rated their FMS symptoms and physical abilities as better than when they were pretested for the program. Up to 35 percent had periods of time without symptoms and nearly 50 percent rated their general health as good or excellent. A majority of patients whether they finished the program or not took medications for sleep, exercised, and used relaxation and self-talk coping strategies. Use of both pain medications and anti-depressants increased over the course of the study. Conclusions: Patients treated in a comprehensive program had consistently lower FMS impact, depression, pain, and fatigue scores over time. Patients who did not enter or complete the program were as likely take sleep medication, exercise or use self-management techniques over time but did not perceive themselves to be doing as well as those who completed the program.