A Mobile Application to Help Self-Manage Pain Severity, Anxiety, and Depressive Symptoms in Patients with Fibromyalgia Syndrome: A Pilot Study 2022

Abstract
Treatment for individuals with fibromyalgia syndrome (FMS) is complex and is not always accessible to those who could benefit. The aim of this study was to conduct a preliminary evaluation of a mobile-app-delivered, cognitive behavioral treatment (CBT)-based intervention in helping adults self-manage fibromyalgia symptoms.

A total of 100 adults with FMS (M [SD] age = 49.81, [9.99] years; 94% women) were given access to the digital treatment program and downloaded the app. Pain severity, anxiety symptoms, depression symptoms, fatigue, and sleep quality were assessed at pre-treatment, post-treatment, and 3-month follow-up. Fifty-three of the potential participants completed the 47-day treatment. Data showed significant improvements in pain severity (p = 0.007, d = 0.43), anxiety (p = 0.011, d = 0.40) and depressive symptoms (p = 0.001, d = 0.50) from pre-treatment to post-treatment.

The effect sizes associated with app use are consistent with improvements seen in previously published clinical trials of CBT for FMS. Improvements were generally maintained, although there was some decrease in the outcomes from post-treatment to the 3-month follow-up. Most participants reported that they were very satisfied with the app.

The use of the app was associated with similar levels of improvements found with in-person CBT treatment for FMS. Research to evaluate the effectiveness of the app in a controlled trial is warranted.

https://www.mdpi.com/1660-4601/19/19/12026

 

Purpose of this loose pilot study seems to be to compare to in-person CBT vs this app (called Fibroline, originally developed in a pediatric pain department).

Not a lot of subjects. No detailed knowledge of subjects (whether or not they were using other pain control measures, for example).

Interesting finding that pain intensity didn't significantly lessen with the use of the app. No surprise to this FM person.

Seven day baseline data, twice a day: fatigue levels, anxiety, pain intensity, depression, sleep quality. CBT modules offered in various forms. Don't know if they were mandatory or how these were tracked as attended or comprehended. 47 days of this form of CBT. Then a post-test and a followup at 3 months (not sure of timing of that 3 months followup, 3 months after which measure?).

The subjects could see the "evolution" of their responses over time. This would prejudice the data, in my opinion, toward responding more positively so as to see your "improvement" in colorful representation on the app. Does using an app itself, the novelty, the technological fact of it, skew the responses to the positive? In other words, does using an app set one up for a false expectation of miraculously improving?

Not much effect on sleep quality or fatigue.

Anxiety levels were assessed by responding to the question: "in the last 7 days what was your level of anxiety" on a Likert scale. In the last seven days? Doesn't anxiety vary by the hour?

I am curious about some of the instruments used. They may be rather simplified. The fatigue instrument had only six levels, for example, in visuals.

 

Seriously. When your entire "expertise" can be replaced by a generic interactive pamphlet, your "expertise" is a complete sham. And many studies finding the interactive pamphlets are just as useless as "high-intensity" CBT from "highly-trained professionals".

And I mean this large and wide applying to any level of expertise. Even a domestic cleaner can't be replaced by an app. That's how garbage their fake expertise is.

 

Bottom line is that fibromyalgia contains much more complexity than CBT can begin to work with.

CBT believes in Santa Claus or that they are Santa Claus.

That all the symptloms and sequelae can be overcome.