Abstract
ObjectiveThe aim was to assess the feasibility and acceptability of a telephone-based cognitive behaviour therapy (tCBT) intervention for individuals with axial SpA (axSpA), with and without co-morbid FM, and to measure the change in patient-reported health outcomes.MethodsA convenience sample of individuals recruited from British Society for Rheumatology Biologics Registry for AS (BSRBR-AS) sites were offered a course of tCBT (framed as coaching). Patient-reported outcomes were measured at baseline and on course completion. Semi-structured qualitative interviews assessed intervention acceptability. Thematic analysis was informed by the theoretical framework of acceptability.ResultsForty-two participants attended for initial assessment. Those completing at least one tCBT session (n = 28) were younger, more likely to meet classification criteria for FM (57 vs 29%) and reported higher disease activity. Modest improvements were reported across a range of disease activity and wider health measures, with 62% of patients self-rating their health as improved (median 13 weeks post-intervention). Twenty-six participants were interviewed (including six who discontinued after initial assessment). tCBT was widely acceptable, offering a personalized approach. Despite low or unclear expectations, participants described improved sleep and psychological well-being and gained new skills to support self-management. Reasons for non-uptake of tCBT centred on lack of perceived need and fit with individual value systems. Many felt that tCBT would be most useful closer to diagnosis.ConclusionHigher uptake among axSpA patients with co-morbid FM suggests that these individuals have additional needs. The findings are helpful in identifying patients most likely to engage with and benefit from tCBT and to maximize participation.
Original language | English |
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Article number | rkaa063 |
Number of pages | 10 |
Journal | Rheumatology Advances in Practice |
Volume | 5 |
Issue number | 2 |
Early online date | 17 Nov 2020 |
DOIs | |
Publication status | Published - 2021 |
Bibliographical note
Acknowledgements:We thank Elizabeth Jones who was study co-ordinator. We are also grateful to the staff of the British Society for Rheumatology Biologics Register in Axial Spondyloarthritis register who at the time of the study were Elizabeth Ferguson-Jones, Maureen Heddle, Nafeesa Nazlee and Barry Morris, and to the recruiting staff at the clinical centres, details of which are available at:
https://www.abdn.ac.uk/iahs/research/epidemiology/spondyloarthritis.php#panel1011. We would like to thank the patient-partner representatives from the National Axial Spondyloarthritis Society (NASS) and all the participants who contributed to this research.
Funding:
This work was supported by Versus Arthritis (Grant No: 21378) who funded the FOMAxS study. The BSRBR-AS is funded by the British Society of Rheumatology who have received funding for this, in part, from Pfizer, Abbvie and UCB. These companies receive advance copies of results but have no input in determining the topics for analysis or work involved in undertaking it.
Keywords
- axial spondyloarthritis
- fibromyalgia
- telephone-based cognitive behavioural therapy
- feasibility