Mindfulness levels in patients with fibromyalgia following recommended pharmacological treatment: A multicenter, uncontrolled, one-year follow-up study

Objectives

To assess the change in mindfulness levels at a one-year follow-up visit in patients with fibromyalgia (FM) who were following recommended pharmacological treatment and to identify the variables related to that change.

Methods

A one-year, uncontrolled, two-wave longitudinal multicentre study design. The study sample consisted of patients (n=269) with FM in primary care settings. Patients received the recommended pharmacological treatment for FM (pregabalin and, if they were diagnosed with depression, duloxetine). The main outcome variable was mindfulness, as measured by the Mindful Attention Awareness Scale (MAAS). Other psychological variables evaluated in this study included pain catastrophising, pain acceptance, mental defeat, psychological inflexibility, perceived injustice, and positive and negative affect. Spirituality, anxiety, depression, global function, pain and quality of life were also assessed.

Results

FM patients who followed recommended pharmacological treatment in primary care settings improved with regard to general function and pain (Cohen's d, 0.52 and 0.50, respectively) but decreased with regard to their mindfulness levels (d=0.49). After controlling for baseline mindfulness values, the variables included in the model that explained changes in mindfulness (r2=0.958, r2 change=0.140, p<0.001) were anxiety, pain acceptance, spirituality and psychological inflexibility. The final equation was significant, F(6,193)=21.96, p<0.001, and the model explained 95.83% of the variance.

Conclusion

This investigation is the first study to confirm that mindfulness levels decrease in FM patients who receive recommended pharmacological treatment. The identification of psychological variables that are related to this decrease can help to modify FM treatment protocols to increase treatment efficacy.