Economic evaluations of educational, physical, and psychological treatments for fibromyalgia: a systematic review with meta-analysis

Autor(es)

Cabral, Cristina Maria Nunes ^{[1, 2]} ; Miyamoto, Gisela Cristiane ^{[1, 2]} ; Franco, Katherinne Ferro Moura ^[1] ; Bosmans, Judith Ekkina ^[2]

Afiliação do(s) autor(es)

^[1] Univ Cidade Sao Paulo, Masters & Doctoral Programs Phys Therapy, Rua Cesario Galeno 475, BR-03071000 Sao Paulo, SP - Brazil

^[2] Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Fac Sci, Dept Hlth Sci, Amsterdam - Netherlands

• Tipo de documento: Artigo de Revisão
• Fonte: Pain; v. 162, n. 9, p. 2331-2345, SEP 2021.
• Citações Web of Science: 2

Resumo

Nonpharmacological interventions are recommended for the treatment of fibromyalgia, but there is a lack of knowledge about the cost-effectiveness of these interventions. The aim of this study was to systematically review economic evaluations of educational, physical, and psychological interventions for the treatment of fibromyalgia. The search was performed in PUBMED, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database, PsycINFO, EconLit, National Health Service Economic Evaluation Database, and Health Technology Assessment. Economic evaluations of educational, physical, and psychological interventions for adult patients with fibromyalgia were included. Primary outcomes were healthcare and societal costs, and quality-adjusted life-years, and secondary outcomes were any disease-specific clinical outcome. Costs and effects were pooled in a meta-analysis, when possible. Eleven studies were included, of which 7 compared a psychological intervention with another intervention or usual care/control. Over a 6-month time horizon, healthcare and societal costs of the psychological intervention were significantly lower than usual care (mean difference: \$-2087, 95% confidence interval {[}CI]: -3061 to -1112; mean difference: \$-2411, 95% CI: -3582 to -1240, respectively), and healthcare costs were significantly lower for the psychological intervention compared with a pharmacological intervention (mean difference: \$-1443, 95% CI: -2165 to -721). Over a 12-month time horizon, healthcare costs for the psychological intervention were significantly lower than for usual care (mean difference: \$-538, 95% CI: -917 to -158). Incremental cost-effectiveness ratios for quality-adjusted life-years and impact of fibromyalgia showed that the psychological intervention was cost-effective compared with other interventions and control conditions. There is a need of more economic evaluations conducted alongside randomized controlled trials with interventions recommended for the treatment of fibromyalgia, such as physical exercise. (AU)

• Processo FAPESP: 19/13744-4 - Avaliação econômica no tratamento de pacientes com fibromialgia
• Beneficiário: Cristina Maria Nunes Cabral
• Modalidade de apoio: Bolsas no Exterior - Pesquisa
• Processo FAPESP: 18/07599-9 - Avaliação econômica no tratamento da dor musculoesquelética crônica
• Beneficiário: Gisela Cristiane Miyamoto
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado