The following is a summary of “Efficacy, acceptability and safety of acceptance and commitment therapy for fibromyalgia – a systematic review and meta-analysis,” published in the December 2023 issue of Pain by Eastwood et al.

While acceptance and commitment therapy (ACT) shows promise for chronic pain, its effectiveness in treating the specific challenges of fibromyalgia (FM), marked by widespread pain, fatigue, and cognitive symptoms, remains understudied.

Researchers conducted a retrospective study and delved into past studies to determine if acceptance and commitment therapy effectively ease the burdens of fibromyalgia.

They searched PubMed, Embase, and PsychInfo databases. Eligible for inclusion were RCTs with participants having FM intervention based on the ACT framework/model without combining with any other active therapy; any non-ACT control was accepted. A meta-analysis was conducted with primary outcomes including pain acceptance chronic pain acceptance questionnaire (CPAQ), health-related quality of life (fibromyalgia impact questionnaire, FIQ), attrition rate, and frequency of adverse events. Secondary outcomes comprised pain intensity, disability, depression, anxiety, and fatigue.

The results showed the incorporation of six RCTs, encompassing a total of 384 participants, predominantly female. ACT was administered through online platforms, group sessions, or individual sessions. ACT analyzed its superiority over controls by enhancing FIQ scores at post-intervention (SMD −1.05, 95% CI −2.02, −0.09) and follow-up (SMD −1.43, 95% CI −2.17, −0.69) and CPAQ scores at post-intervention (SMD 1.05, 95% CI 0.61, 1.49) and follow-up (SMD 0.95, 95% CI 0.40, 1.49). Attrition rates were below 20% in 4 out of 6 studies, and no adverse events attributable to ACT were reported. ACT’s benefit for fibromyalgia soared across the board, with significant improvements in anxiety, depression, pain, fatigue, and disability, holding steady for most even after treatment ended.

They concluded that while limited by study variations, this review found ACT led to sustained improvements in various outcomes for fibromyalgia patients.

Source: journals.sagepub.com/doi/10.1177/20494637231221451