Page 5 - JCTR-9-6

Journal of Clinical and Translational Research 2023; 9(6): 369-380

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

REVIEW ARTICLE

Effectiveness of health education interventions in patients with

fibromyalgia syndrome: an umbrella review

Núria Sempere-Rubio, Sara Mollà-Casanova, Elena Muñoz-Gómez, and Ferran Cuenca-Martínez*
Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, c/Gascó Oliag nº5, 46010, Valencia, Spain

ARTICLE INFO ABSTRACT

Article history: Background: Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain that
Received: August 29, 2023 is accompanied by emotional distress, fatigue, tender points of pain, sympathetic nervous system
Revised: September 26, 2023 disturbances, and alterations in the quality of sleep.
Accepted: September 30, 2023 Aim: The main aim of this umbrella review was to assess the effectiveness of health education
Published Online: November 9, 2023 interventions (HEI) in patients with FMS.
Methods: We searched in PubMed, PEDro, EMBASE, CINAHL, Psicodoc, and Google Scholar
Keywords: (August 6, 2022). The outcomes measures were pain intensity, quality of life, functionality, anxiety,
Health education and pain catastrophizing. This review was previously registered in the international prospective
Pain neuroscience education register of systematic reviews (SR) PROSPERO (CRD42022368068). Methodological quality was
Pain physiology education analyzed using AMSTAR and ROBIS scale, and the strength of evidence was established according to
Fibromyalgia syndrome the guidelines advisory committee grading criteria.
Results: Five SR with and without meta-analysis were included in the study. The results were
*Corresponding author: pooled to assess the effects of HEI in isolation and to assess the effects of HEI in combination with
Ferran Cuenca-Martínez other interventions (multicomponent approach based on therapeutic exercise or pharmacological).
Department of Physiotherapy, Faculty of The results showed that HEI combined with other interventions was effective in improving pain
Physiotherapy, University of Valencia, c/Gascó intensity, quality of life, functionality, and anxiety compared to minimal intervention/usual care or no
Oliag nº5, 46010, Valencia, Spain. intervention, although mixed evidence was found improving pain catastrophizing, all with a limited
E-mail: Ferran.Cuenca@uv.es quality of evidence. Regarding HEI in isolation, contradictory evidence was found for pain intensity
and quality of life variables with a limited quality of evidence. Finally, no significant results were
© 2023 Author(s). This is an Open-Access found in improving functionality, anxiety, and pain catastrophizing variables also with a limited
article distributed under the terms of the quality of evidence.
Creative Commons Attribution-Noncommercial Conclusions: Overall, it seems that the addition of HEI to other interventions, mostly therapeutic
License, permitting all non-commercial use,
distribution, and reproduction in any medium, exercise although we could refer to it in terms of a multimodal approach, leads to greater clinical
provided the original work is properly cited. improvements than HEI in isolation. We have seen this especially in some clinical variables of interest
such as pain intensity or quality of life. It seems that the main strength of the HEI is the interaction
with other interventions to enhance its efficacy with respect to the outcomes assessed. Further research
is needed especially ensuring the correct comparison when combining HEI with other interventions to
obtain more consistent results.
Relevance for Patients: Adding therapeutic education programs to the management of patients with
FMS seems to have a clinically important effect. However, the application of therapeutic education in
isolation does not appear to be effective in the management of these patients. More research is needed
in this field.

1. Introduction

Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain that is
accompanied by emotional distress, fatigue, tender points of pain, sympathetic nervous

DOI: http://dx.doi.org/10.18053/jctres.09.202306.23-00108