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ORIGINAL ARTICLE
Year : 2013  |  Volume : 5  |  Issue : 9  |  Page : 546-553

Fibromyalgia symptom reduction by online behavioral self-monitoring, longitudinal single subject analysis and automated delivery of individualized guidance


1 Collinge and Associates, Eugene, OR, USA
2 Optimal Data Analysis, LLC, San Diego, CA, USA
3 Independent Consultant, Glen Burnie, MD, USA

Correspondence Address:
William Collinge
Collinge and Associates, 3986 N Shasta Loop Eugene, OR 97405
USA
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Source of Support: Sponsored by National Institute of Arthritis, Musculoskeletal and Skin Diseases, grant #R44AR052640., Conflict of Interest: None


DOI: 10.4103/1947-2714.118920

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Background: Fibromyalgia (FM) is a complex chronic pain condition that is difficult to treat. The prevailing approach is an integration of pharmacological, psycho-educational, and behavioral strategies. Information technology offers great potential for FM sufferers to systemically monitor symptoms as well as potential impacts of various management strategies. Aims: This study aimed to evaluate effects of a web-based, self-monitoring and symptom management system (SMARTLog) that analyzes personal self-monitoring data and delivers data-based feedback over time. Materials and Methods: Subjects were self-referred, anonymous, and recruited via publicity on FM advocacy websites. Standardized instruments assessed health status, self-efficacy, and locus of control at baseline and monthly during participation. Subjects were encouraged to complete the SMARTLog several times weekly. Within-subject, univariate, and multivariate analyses were used to derive classification trees for each user associating specific behavior variables with symptom levels over time. Results: Moderate use (3 times weekly x 3 months) increased likelihood of clinically significant improvements in pain, memory, gastrointestinal problems, depression, fatigue, and concentration; heavy use (4.5 times weekly x five months) produced the above plus improvement in stiffness and sleep difficulties. Conclusions: Individualized, web-based behavioral self-monitoring with personally-tailored feedback can enable FM sufferers to significantly reduce symptom levels over time.


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