Evid Based Med doi:10.1136/ebmed-2012-100781
  • Therapeutics
  • Randomised controlled trial

Telephone-based cognitive-behavioural therapy and a structured exercise programme are effective for chronic widespread pain (fibromyalgia)

  1. Kurt Kroenke
  1. Correspondence to Kurt Kroenke
    Indiana University School of Medicine, 1050 Wishard Blvd, Regenstrief Institute, 5th Floor, Indianapolis, Indiana 46202, USA; kkroenke{at}

Commentary on:


Chronic widespread pain (CWP) is the cardinal feature of fibromyalgia which is one of the three most common musculoskeletal disorders in clinical practice, the others being osteoarthritis and chronic low back pain. CWP is disabling as well as costly and difficult to treat.


In a 2×2 factorial randomised controlled trial, 442 patients with CWP were randomised to receive 6 months of telephone-delivered cognitive-behavioural therapy (TCBT), a structured exercise programme, combined TBCT-exercise or treatment as usual (TAU). The primary outcome, using a 7-point patient global assessment scale of change in health, was assessed at baseline and 6 months (intervention end) and 9 months after randomisation. A positive outcome was defined as ‘much better’ or ‘very much …