MAintaining MusculOskeleTal Health (MAmMOTH)

MAintaining MusculOskeleTal Health (MAmMOTH)

Duration: 01 March 2015 - 31 March 2020 (analysis ongoing)
Funder: Versus Arthritis
Chief investigator: Professor Gary Macfarlane
Study co-ordinator: Marcus Beasley

The MAmMOTH study aims to find out if a short-course of cognitive behavioural therapy, or CBT, over the telephone prevents development of chronic widespread pain (CWP) in people at high risk. It is important to manage the symptoms of CWP as quickly as possible because the longer it lasts the less chance there is of being able to successfully treat it. 

Patients who visited their GP with pain and reported other symptoms which mean they are at high risk of CWP, were initially recruited from March 2015 - March 2017. Half of those taking part were then allocated to sessions of CBT on the phone with a trained therapist over a seven weeks, with booster sessions three and six months later. Sessions were specific to each individual, and participants were encouraged to identify helpful and unhelpful thoughts and feelings related to their symptoms, to find ways to overcome everyday problems, and to build in aspects of a healthy lifestyle to their daily routine. Additionally there was a control arm of the trial, where people received the care their doctor would normally provide.

Recruitment was completed at the end of March 2017 with over 1000 people taking part, and the study completed follow up in July 2019.


Further information

What are the aims of this research?

The aim of this research project is to investigate the success of cognitive behaviour therapy by telephone in preventing the development of chronic widespread pain (CWP) in fibromyalgia patients and to assess its cost effectiveness.

Why is this research important?

Patients with fibromyalgia commonly experience CWP in their muscles, tendons and ligaments. It is important to manage the symptoms of CWP as quickly as possible because the longer pain lasts, the less likelihood there is of being able to successfully treat it. However, CWP is very difficult to treat, so therapies which reduce the risk of a patient developing the condition are needed Previously, this research group demonstrated that when patients with CWP received a form of talking therapy called cognitive behaviour therapy by telephone, they experienced long-lasting improvements in their symptoms.

How will this research benefit patients?

If this full trial of telephone-delivered cognitive behavioural therapy is successful, it will be the first treatment to reduce the number of patients with fibromyalgia and related conditions who develop CWP. Cognitive behavioural therapy by telephone promises to be cost-effective for the NHS so if it is found to be beneficial, it may lead to a preventative strategy which could be widely available.

What has the study found so far?


You can read the main results of the study here:

Plain Language Summary for this paper is available here.

Other publications from studies using study data

Study locations

Study newsletter

Read updates from the study including staff and recruitments from our newsletter update.

Patient manual

You can read details of the cognitive behavioural therapy (CBT) programme in our patient manual. Please click the link below to download.

Contact details

Questions regarding this study can be directed to study coordinator Marcus Beasley at the following address: