052 Occupational therapy-led fibromyalgia self-management education group programme : patients’ perspectives

Background: Fibromyalgia (FM) is characterised by the symptoms of chronic widespread pain, fatigue, unrefreshed sleep, cognitive difficulties and affects approximately one in 20 people in the UK. The EULAR revised guidelines for the management of FM recommended that non-pharmacological interventions should be prioritised. Occupational therapists at the Rheumatology Outpatients Department, Leighton Hospital, Mid Cheshire NHS Hospitals Foundation Trust developed the Fibromyalgia Self-Management Education (FAMe) Group Programme, with extensive research and patient partner involvement. The primary aim of this programme is to support self-management of FM using behaviour change interventions as outlined in the NICE recommendations. FAMe comprises 2.5 hrs weekly sessions over six weeks (6-Wks) and core components include education about FM, pain, fatigue, sleep and mood management, dealing with dyscognition, physical exercise and practicing mindfulness, based on Cognitive Behavioural Therapy (CBT) and Motivational Interview (MI) approaches. Methods: Patients with a primary diagnosis of FM, were screened and recruited from the rheumatology department of the Leighton Hospital by occupational therapists. Following the completion of the 6-Wks FAMe Group Programme, focus groups (FG) were held at the hospital to obtain patient perspectives on the programme content, delivery and impact on their self-management. In total, 14 patients aged between 19 to 67 attended three focus groups [FG1: n = 6 [F] FG2: n = 3 [F] FG3: n = 5 [2M:3F]]. Transcriptions were analysed by three independent researchers, not involved in the initial design or the delivery of this programme, using thematic analysis under the theoretical framework of critical realism. Results: Focus groups findings indicated that patients have greatly valued the support they have received from the group members and made significant behaviour changes both during and following the completion of the 6-Wks programme. These included: increasing physical activity levels, better stress, pain and mood management, and becoming more assertive. They have gained self-awareness and felt empowered to make the lifestyle changes they needed to better manage their symptoms. A strong theme about the need for health professionals to be more empathetic and knowledgeable about FM have emerged, as patients felt that many people with FM are not getting the support they need from clinicians. Importance of the need for educating the significant others and families was emphasised, as the lifestyle changes they needed to make involved changes to the roles, responsibilities and daily routines of others, which were deemed as a main barrier to making behavioural changes. Conclusion: Patients perceived the FAMe programme as highly acceptable and beneficial to self-management. The importance of educating families and health professionals on FM was stressed. Future interventions should aim to inform and educate clinicians and families of people with FM to create a supportive environment that would enable them to make behavioural and lifestyle changes they need to enhance self-management