Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry

Objective Relationships between patient education and long-term clinical outcomes are complex. This study used real-world data to evaluate the impact of improved pain knowledge on clinical outcomes in fibromyalgia patients.Methods Prospectively collected registry-based observational data were analys...

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Main Authors: Robin Christensen, Marius Henriksen, Eva Ejlersen Wæhrens, Kirstine Amris, Pernille Hurup Duhn
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/2/e005576.full
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author Robin Christensen
Marius Henriksen
Eva Ejlersen Wæhrens
Kirstine Amris
Pernille Hurup Duhn
author_facet Robin Christensen
Marius Henriksen
Eva Ejlersen Wæhrens
Kirstine Amris
Pernille Hurup Duhn
author_sort Robin Christensen
collection DOAJ
description Objective Relationships between patient education and long-term clinical outcomes are complex. This study used real-world data to evaluate the impact of improved pain knowledge on clinical outcomes in fibromyalgia patients.Methods Prospectively collected registry-based observational data were analysed to emulate a randomised clinical trial. Study participants were diagnosed with fibromyalgia, had a high need to learn about pain (Numeric Rating Scale >7), had attended a 2-day therapeutic educational programme and re-rated their learning needs after the programme. A good educational outcome was defined as a re-rating score <5, while a poor outcome was ≥5. The primary endpoint at 9 months was the overall impact of fibromyalgia, measured by the Fibromyalgia Impact Questionnaire Revised (FIQR) impact subscale.Results The eligible cohort comprised 450 participants. The intention-to-treat from population included 121 participants (26.9%) with a good educational outcome and 329 participants (73.1%) with a poor educational outcome (comparator group). Missing outcome data were handled implicitly by the repeated measures linear mixed models, assuming data are missing at random.At the 9-month endpoint, the fully adjusted FIQR impact subscale score was lower in the good educational outcome group (8.0 (95% CI 7.3 to 8.7)) compared with the poor educational outcome group (9.6 (95% CI 9.0 to 10.2)), indicating a better clinical outcome for those with a good educational outcome. The model-estimated between-group difference was −1.6 (95% CI −2.5 to −0.7; p=0.0006) FIQR impact subscale units.Conclusions This study suggests that achieving pain educational learning objectives leads to better clinical outcomes in fibromyalgia patients, supporting the integration of pain education into patient programmes.
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spelling doaj-art-a393131e8d604d66a2fdff0eecc3e1412025-08-20T03:21:22ZengBMJ Publishing GroupRMD Open2056-59332025-06-0111210.1136/rmdopen-2025-005576Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registryRobin Christensen0Marius Henriksen1Eva Ejlersen Wæhrens2Kirstine Amris3Pernille Hurup Duhn4The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, DenmarkThe Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, DenmarkThe Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, DenmarkThe Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, DenmarkThe Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, DenmarkObjective Relationships between patient education and long-term clinical outcomes are complex. This study used real-world data to evaluate the impact of improved pain knowledge on clinical outcomes in fibromyalgia patients.Methods Prospectively collected registry-based observational data were analysed to emulate a randomised clinical trial. Study participants were diagnosed with fibromyalgia, had a high need to learn about pain (Numeric Rating Scale >7), had attended a 2-day therapeutic educational programme and re-rated their learning needs after the programme. A good educational outcome was defined as a re-rating score <5, while a poor outcome was ≥5. The primary endpoint at 9 months was the overall impact of fibromyalgia, measured by the Fibromyalgia Impact Questionnaire Revised (FIQR) impact subscale.Results The eligible cohort comprised 450 participants. The intention-to-treat from population included 121 participants (26.9%) with a good educational outcome and 329 participants (73.1%) with a poor educational outcome (comparator group). Missing outcome data were handled implicitly by the repeated measures linear mixed models, assuming data are missing at random.At the 9-month endpoint, the fully adjusted FIQR impact subscale score was lower in the good educational outcome group (8.0 (95% CI 7.3 to 8.7)) compared with the poor educational outcome group (9.6 (95% CI 9.0 to 10.2)), indicating a better clinical outcome for those with a good educational outcome. The model-estimated between-group difference was −1.6 (95% CI −2.5 to −0.7; p=0.0006) FIQR impact subscale units.Conclusions This study suggests that achieving pain educational learning objectives leads to better clinical outcomes in fibromyalgia patients, supporting the integration of pain education into patient programmes.https://rmdopen.bmj.com/content/11/2/e005576.full
spellingShingle Robin Christensen
Marius Henriksen
Eva Ejlersen Wæhrens
Kirstine Amris
Pernille Hurup Duhn
Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry
RMD Open
title Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry
title_full Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry
title_fullStr Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry
title_full_unstemmed Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry
title_short Impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self-reported pain education needs: a target trial emulation using the DANFIB registry
title_sort impact of enhanced pain knowledge on core outcomes in fibromyalgia patients with high self reported pain education needs a target trial emulation using the danfib registry
url https://rmdopen.bmj.com/content/11/2/e005576.full
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