Study protocol for a three-arm randomized controlled trial investigating the effectiveness, cost-utility, and physiological effects of a fully self-guided digital Acceptance and Commitment Therapy for Spanish patients with fibromyalgia.

Journal: Digital health

Volume: 10

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland. Unitat d'Expertesa en Síndromes de Sensibilització Central, Servei de Reumatologia, Vall d'Hebron Hospital, Barcelona, Spain. Department of Clinical and Health Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra, Spain. Parc Sanitari Sant Joan De Déu, Sant Boi De Llobregat, Spain. Department of Basic, Developmental and Educational Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra, Spain. Department of Biochemistry and Molecular Biomedicine & Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain. Unit of Zoology and Biological Anthropology, Department of Evolutionary Biology, Ecology and Environmental Sciences & Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain. CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. Swing Therapeutics, Inc, San Francisco, CA, USA. Department of Psychology, Uppsala University, Uppsala, Sweden.

Abstract summary 

Fibromyalgia (FM) is a prevalent pain syndrome with significant healthcare and societal costs. The aim of the SMART-FM-SP study is to determine the effectiveness, cost-utility, and physiological effects in patients with FM of a digital intervention (STANZA®) currently marketed in the United States, which delivers smartphone-based, fully self-guided Acceptance and Commitment Therapy (Digital ACT) for treating FM-related symptoms.A single-site, parallel-group, superiority, randomized controlled trial (RCT) will be conducted, including a total of 360 adults diagnosed with FM. Individuals will be randomly allocated (1:1:1) to treatment as usual (TAU), to TAU plus 12 weeks of treatment with Digital ACT, or to TAU plus 12 weeks of treatment with digital symptom tracking (i.e. FibroST). Participants will be assessed at baseline, post-treatment, and 6-month follow-up. An intention-to-treat analysis using linear mixed models will be computed to analyze the effects of Digital ACT on functional impairment (primary outcome), as measured by the Fibromyalgia Impact Questionnaire Revised at 6 months from the inception of the treatment. Secondary outcomes include impression of change, symptoms of distress, pain catastrophising, quality of life, cost-utility, and selected biomarkers (cortisol and cortisone, immune-inflammatory markers, and FKBP5 gene polymorphisms). The role of ACT-related processes of change will be tested with path analyses.This study is the first RCT that tests Digital ACT for Spanish patients with FM. Results will be important not only for patients and clinicians, but also for policy makers by examining the cost-utility of the app in a public healthcare context.

Authors & Co-authors:  Gallego Serrat Royuela-Colomer Sanabria-Mazo Borràs Esteve Grasa Rosa Rozadilla-Sacanell Almirall D'Amico Dai Rosenbluth McCracken Navarrete Feliu-Soler Luciano

Study Outcome 

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Statistics
Citations :  Clauw DJ. Fibromyalgia. JAMA 2014; 311: 1547.
Authors :  17
Identifiers
Doi : 20552076241239177
SSN : 2055-2076
Study Population
Male,Female
Mesh Terms
Other Terms
Acceptance and Commitment Therapy;Fibromyalgia;biomarkers;chronic pain;cost-utility;mHealth technology;mobile applications;smartphone
Study Design
Study Approach
Country of Study
Publication Country
United States