Please select the eligibility criteria that correspond to the clinical trial below.
Title: Stimulating Self Management in Patients With Fibromyalgia Through Web-based Situational Feedback
Brief Summary: The overall objective of this randomized controlled study (RCT) financed by the Norwegian Research Council (grant no. 182012/V50) is to establish the effectiveness of situational feedback to the self-management of fibromyalgia syndrome (FMS) using innovative means of patient-provider communication in a randomized controlled study (RCT). Thereby this project will contribute to the knowledge of treatment of patients with FMS. The effectiveness of the intervention will be expressed in terms of a) reduced pain, b) psychometric outcomes, c) quality of life, d) improved engagement in daily activities and e) prevented transition to chronic disability. We furthermore aim to 1) determine the effectiveness of providing regular situational feedback in enhancing self-management and, consequently 2) study the effectiveness of enhancing self-management in reducing pain and physical disability.

Self-management of chronic pain is increasingly seen as an important tool in providing adequate care to patients with FMS and other types of Chronic Non-malignant Pain. Enhancing the patient's self-management of her/his condition is thought to be effective in reducing pain and disability. However, sufficient empirical evidence to support this is yet unavailable. This may be due to the non-situational nature of many interventions studied so far: Patients are taught management skills in a clinical setting, and may not be able to successfully use these skills in daily care. Therefore, enhancing self-management of chronic pain, by providing immediate feedback that is directly related to patient's daily life ("situational" feedback) complementary to care-as usual, is thought to be more effective than conventional interventions in a clinical setting. This may even be even more effective when the patient receives quick response feedback using mobile communication technology, i.e. any place any time.


Options:
A: DISEASE CHARACTERISTICS:

* Diagnosis of cancer AND 1 or both of the following:

  * Clinical depression

    * Depression must be of at least moderate severity (PHQ-9 score ≥ 10)

      * Depressed mood and/or anhedonia endorsed
    * No depression directly precipitated by cancer therapy for which depression is a well known side effect (e.g., interferon, corticosteroids)
  * Cancer-related pain

    * Pain must be at least moderate in severity (Brief Pain Inventory score ≥ 6), persisted despite using ≥ 2 analgesics, and cancer-related
    * If the only pain is due to a pre-existing condition (e.g., migraine, headache, arthritis, etc), the patient may not be eligible

PATIENT CHARACTERISTICS:

* Life expectancy ≥ 6 months
* Must speak English
* Not pregnant
* Fertile patients must use effective contraception
* No moderately severe cognitive impairment
* No schizophrenia or other psychosis
* No disability claim currently being adjudicated for pain

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* Not in hospice care
B: Inclusion Criteria:

* Veterans receiving care at the VA Ann Arbor Healthcare System
* Have back pain that has persisted for more than 3 months
* Have a sedentary lifestyle (less than 150 minutes of physical activity per week)
* Have access to a computer (with Windows XP or Vista) on at least a weekly basis with an available USB port and Internet access
* Have a working e-mail address
* Are competent to provide written informed consent
* Are able to communicate in English
* Are not institutionalized
* Can identify a health care provider who can provide medical clearance.

Exclusion Criteria:

* Currently pregnant
* Cannot walk at least one block
* Cannot obtain written clearance to start a walking program from a treating healthcare provider
C: Inclusion Criteria:

* Primary care patients aged 18 and older, of participating physicians within 5 internal medicine practices in Boston
* Registered users of patient-provider internet portal called PatientSite
* Screened positive for depression, chronic pain, or lower extremity mobility difficulty

Exclusion Criteria:

* Current treatment for screened condition by medical or surgical specialist or other appropriate licensed health professional such as a physical therapist or mental health counselor
D: Inclusion Criteria:

* Female, having wide spread pain like FMS (IPCS codes CD-10, 79.0 - coded) for at least three months ,\> 18 years, able to understand Norwegian; able to use the webenabled mobile phone.

Exclusion Criteria:

* substantial psychological problems in need of treatment with intensive psychotherapy.

Answer: D