Background/Purpose: Fibromyalgia (FM) is a syndrome of central sensitization that encompasses many disorders where the central nervous system amplifies sensory input across many organ systems and results in diverse and varied symptoms such as musculoskeletal pain, alteration of sleep and fatigue. FM has a severe impact on the quality of life of patients, affecting work capacity, activities of daily life, as well as social relationships. There is agreement that first-line treatment should include both pharmacological and non-pharmacological interventions. Among the latter, the completion of a health diary is included as a valuable self-help tool to assess and control symptoms and improve activity levels and quality of life. In the context of this study, we designed a health diary to support self-management in patients with FM. The health diary aimed at changing and adjusting health-related behaviors such as pain management, exercise, and rest through practical hints and self-help activities.The purpose is to explore the effect of the use of a health diary in daily self-management in patients with FM.

Methods: Patients diagnosed with primary FM, referred by the rheumatologist, were included in the study and randomly assigned into two groups. All patients received the health diary with correspondent instructions for its completion. In addition to the completion of the health diary, patients in the experimental group participated in a four-weekly guided counseling and education workshop regarding how to handle chores and health-related behaviors while dealing with FM self-management. The counseling and educational workshop was delivered by two occupational therapists. Patients in both groups completed the FIQ (Fibromyalgia Impact Questionnaire) and a visual analog scale of activity-performance (VAS) at baseline (Mi) and again the visual analog scale one month following the intervention (Mf). Means were calculated to assess the impact of the FM. Instead, the initial and final results of the analog scale were compared using the independent Student T-test. All patients received an email address to ask for support if needed.

Results: 30 women, 34 to 75 years old (M = 56), participated in the study. Participants had a moderate-high FM impact FIQ = 52.14 (18-79.08). In total, 14 patients from the experimental group and 6 patients from the control group completed the health diary. The initial and final averages of the VAS were for the experimental group: personal care Mi = 7.06 – Mf = 8.66 (P = .009); household activities Mi = 5.6 – Mf = 7.3 (P = .010); work Mi = 3.06 – Mf = 3.5 (P = .10); social activity Mi = 3.7 – Mf = 5.2 (P = .002). No statistically significant changes were observed in the group that solely completed the health diary.

Conclusion: The health diary, supported by guided counseling and education delivered through workshops, could be a useful strategy to enhance the implementation of healthy habits in patients with FM. While a tailored healthy diary may be an interesting landscape to self-management, additional support may even reinforce and enhance the promotion and maintenance of healthy habits.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/implementation-of-a-health-diary-for-patients-with-fibromyalgia/