KB is member of the German FMS guideline group. She is a licensed psychotherapist for cognitive behavioural therapy. PK: None known. PW: None known. WH is head of the steering committee member of the German FMS guideline group and member of the steering committee for the updated recommendations for the management of FMS of the European League Against Rheumatism (EULAR). He is a member of the medical board of the German Fibromyalgia Association. He is a licensed psychotherapist in systemic therapy and hypnosis.

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Abstract

This systematic review aimed at evaluating the efficacy, acceptability and safety of Internet-based psychological therapies (IPTs) in fibromyalgia syndrome (FMS). Clinicaltrials.gov, Cochrane Library, MEDLINE, PsycINFO and SCOPUS were searched from inception to January 2018. Randomized controlled trials (RCTs) comparing IPTs with controls were analysed. Primary outcomes were ≥50% pain relief, disability, negative mood, acceptability and safety at end of therapy and at 6-month follow up. Effects were summarized by a random effects model using risk differences (RD) or standardized mean differences (SMD) with 95% confidence intervals (CI). Six RCTs using different types of Internet-based cognitive-behavioural therapies [ICBTs] (acceptance-based; exposure-based; traditional) with 493 patients were included. At the end of treatment, ICBTs were superior to controls (waiting list, attention control, treatment as usual) in reducing negative mood (SMD −0.51 [95% CI −0.87 to −0.15]) (moderate quality evidence) and disability (SMD −0.56 [95% CI −1.00 to −0.13]) (moderate quality evidence). There were no statistically significant differences between ICBTs and controls in pain relief of 50% or greater (RD 0.09 [95% CI −0.02 to 0.20] (moderate quality evidence) and acceptability (moderate quality evidence). No data on safety and any outcomes at long-term follow-up compared to controls were found. The data available did not allow statistical comparisons between unguided and guided ICBTs and of ICBTs versus traditional face-to-face therapies. ICBTs provided a clinically relevant benefit over control interventions in reducing negative mood and disability at the end of treatment.

Significance

Internet-delivered cognitive behavioural therapies provided a clinically relevant benefit in reducing negative mood and disability in patients with FMS at the end of treatment if compared to waiting list, treatment as usual and attention controls.

Supporting Information

Filename	Description
ejp1284-sup-0001-FigS1.docxWord document, 47.7 KB	Figure S1 Forest plots of outcomes of ICBTs versus controls at end of treatment.
ejp1284-sup-0002-TableS1.docxWord document, 25 KB	Table S1 Detailed characteristics of included studies.
ejp1284-sup-0003-TableS2.docxWord document, 22.4 KB	Table S2 Details of treatment.
ejp1284-sup-0004-TableS3.docWord document, 70 KB	Table S3 Reported treatment quality.
ejp1284-sup-0005-TableS4.docxWord document, 70 KB	Table S4 Details of risk of bias assessment.
ejp1284-sup-0006-MethodS1.docxWord document, 12.5 KB	Methods S1 Search strategy for MEDLINE.
ejp1284-sup-0007-MethodS2.docxWord document, 17.3 KB	Methods S2 Assessment of risk of bias.
ejp1284-sup-0008-MethodS3.docxWord document, 17.4 KB	Methods S3 Unit of analysis issues, dealing with missing data, assessment of heterogeneity, assessment of publication bias, and References.
ejp1284-sup-0009-MethodS3.docxWord document, 12.7 KB

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

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Volume23, Issue1

January 2019

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Efficacy, acceptability and safety of Internet-delivered psychological therapies for fibromyalgia syndrome: A systematic review and meta-analysis of randomized controlled trials

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Efficacy, acceptability and safety of Internet-delivered psychological therapies for fibromyalgia syndrome: A systematic review and meta-analysis of randomized controlled trials

Correction(s) for this article

Corrigendum

Abstract

Significance

Supporting Information

References

Web references

Citing Literature

References

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