Original Title: Evaluación del abordaje terapéutico multidisciplinar en la calidad de vida de pacientes con trastornos del movimiento funcional

Authors' objectives: To assess the clinical effectiveness and safety of the multidisciplinary approach in patients with functional movement disorders (FMD).

Authors' results and conclusions: Results 5 randomised clinical trials have been included with a total of 186 patients published between 2002 and 2024 in 5 countries. All 5 trials analysed the effects of the multidisciplinary approach on the quality of life of patients diagnosed with FMD. The safety of the multidisciplinary therapeutic approach was assessed in all randomised clinical trials, with an overall low incidence of adverse events. Most adverse effects occurred in the control group, with isolated episodes, while in the intervention groups these events were less frequent and mostly mild or transient. The available evidence suggests that the multidisciplinary approach in patients with FMD shows a statistically significant, and in some cases clinically relevant, beneficial effect on quality of life, especially in its physical dimension, with significant improvements in the short term. However, the effect on global and mental quality of life is less consistent and does not seem to be sustained in the long term, suggesting limited or duration-dependent efficacy. In terms of motor function, a significant improvement is observed in the short and medium term in the intervention group, although this tends to equalise with the control group in assessments at 12 months. With regards to psychological state, the result is heterogeneous and inconclusive, although some longitudinal studies suggest a progressive improvement in depressive and somatoform symptoms. The overall clinical evaluation shows a significant reduction in the severity of FMD in the intervention group, with possible maintenance of the effect in the long term. Scarce evidence was found on social, economic impact or patient or professional satisfaction. Conclusions The available evidence suggests that the multidisciplinary approach in patients with FMD is safe and without clinically relevant adverse effects. Statistically significant, clinically relevant in some cases, short-term benefits in the physical domain of quality of life and improvements in motor function have been observed, although evidence on their long-term sustainability is limited. Effects on psychological state, general health, and social impact are more heterogeneous and require further research, while aspects such as patient and professional satisfaction and the economic impact of the multidisciplinary approach have not been addressed in the included studies. Overall, although the multidisciplinary approach shows a possible therapeutic potential in relevant areas, the methodological heterogeneity and the scarce quality of the available evidence underline the need for future studies with more rigorous and comprehensive outcome assessments.

Authors' methods: Methods A review of the scientific literature was conducted using the main electronic databases without time restrictions. Clinical trials evaluating the effect of a multidisciplinary approach on quality of life, as well as motor and psychological outcomes in patients diagnosed with FMD, were included. A validated tool was used to assess the risk of bias in the included studies. The review and selection of studies, as well as the synthesis and assessment of the quality of the evidence, were carried out independently and blindly by two reviewers.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/evaluacion-del-abordaje-terapeutico-multidisciplinar-en-la-calidad-de-vida-de-pacientes-con-trastornos-del-movimiento-funcional/

Year Published: 2025

URL for published report: https://www.aetsa.org/download/publicaciones/TMF_Abordaje-terapeutico_web.pdf

Requestor: Spanish Health Ministry

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

DOI: 10.52766/WEFJ4281

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: <p>Andalusian Agency for Health Technology Assessment (AETSA)</p>