Stimulating self-management in patients with fibromyalgia syndrome through web-based situational feedback

Self-management of chronic pain is increasingly seen as an important tool in providing adequate care to patients with Fibromyalgia Syndrome (FMS) and other types of Chronic Non-malignant Pain. Enhancing the patient's self-management of his condition is th ought to be effective in reducing pain and disability. However, sufficient empirical evidence to support this is yet unavailable. This may be due to the non-situational nature of many interventions studied so far: patients are taught management skills in a clinical setting, and may not be able to successfully use these skills in daily care. Therefore, enhancing self-management of chronic pain, by providing feedback that is directly related to patient's daily life (situational feedback) complementary to ca re-as usual, is thought to be more effective than conventional interventions in a clinical setting. This may even be stronger when the patient receives feedback using mobile communication technology, i.e. any place any time. The proposed study aims to ex amine the extent to which a web-based-telemedicine-intervention influences cognitions and complaints in patients with fibromyalgia by giving situational feedback in response to patient's daily electronic input using a web based infrastructure. It is hypot hesized that immediate situational feedback is more effective than usual care by GP alone In this present study randomized controlled trial (RCT) eighty patients suffering from FMS for at least three months will be recruited through their GP. The experim ental group will be counseled by a clinical nurse specialist through the internet and mobile phones. They will maintain four daily diaries during five weeks and receive situational feedback twice a day from the nurse during four of these five weeks.