Article

PURPOSE: To identify outcome predictors for multidisciplinary treatment in
patients with chronic widespread pain (CWP) or fibromyalgia (FM). METHODS: A
systematic literature search in PubMed, PsycINFO, CINAHL, Cochrane Library,
EMBASE and Pedro. Selection criteria included: age over 18; diagnosis CWP or FM;
multidisciplinary treatment; longitudinal study design; original research report.
Outcome domains: pain, physical functioning, emotional functioning, global
treatment effect and 'others'. Methodological quality of the selected articles
was assessed and a qualitative data synthesis was performed to identify the level
of evidence. RESULTS: Fourteen studies (all with FM patients) fulfilled the
selection criteria. Six were of high quality. Poorer outcome (pain, moderate
evidence; physical functioning and quality of life, weak evidence) was predicted
by depression. Similarly, poorer outcome was predicted by the disturbance and
pain profile of the Minnesota Multiphasic Personality Inventory (MMPI), strong
beliefs in fate and high disability (weak evidence). A better outcome was
predicted by a worse baseline status, the dysfunctional and the adaptive copers
profile of the Multidimensional Pain Inventory (MPI), and high levels of pain
(weak evidence). Some predictors were related to specific multidisciplinary
treatment (weak evidence). Inconclusive evidence was found for other demographic
and clinical factors, cognitive and emotional factors, symptoms and physical
functioning as predictors of outcome. DISCUSSION: It was found that a higher
level of depression was a predictor of poor outcome in FM (moderate evidence). In
addition, it was found that the baseline status, specific patient profiles,
belief in fate, disability, and pain were predictors of the outcome of
multidisciplinary treatment. Our results highlight the lack of high quality
studies for evaluating predictors of the outcome of multidisciplinary treatment
in FM. Further research on predictors of multidisciplinary treatment outcome is
needed.

Langue : ANGLAIS