Interdisciplinary Consensus Document for the treatment of fibromyalgia

Abstract

Backgrounds. The elevated prevalence and enormous clinical and social impact of fi bromyalgia, together with the complexity of its treatment, require action consensuses that guide health care professionals. Although there are some similar documents in our language, most have been made from the perspective of a single discipline.

Objective. To develop a consensus on the treatment of fi bromyalgia made by selected representatives and supported by the principal medical associations that intervene in its treatment (rheumatology, neurology, psychiatry, rehabilitation and family medicine) and representatives of the associations of patients. On the other hand, understanding the disease not as a homogenous disorders but also as the sum of different clinical subtypes, having specifi c symptomatic characteristics and different therapeutic needs is stressed. This approach represented a need perceived by the clinicians and a novelty regarding previous consensuses.

Methods. The different clinical classifi cations proposed in fi bromyalgia and the scientifi c evidence of the treatments used in this disease were reviewed. For the selection of the classifi cation used and performance of the therapeutic recommendations, some of the usual techniques to obtain the consensus (nominal group and brainstorming) were used.

Conclusion. The classifi cation of Giesecke of fi bromyalgia into 3 subgroups seems to have the greatest scientifi c evidence and the most useful for the clinician. The guide offers a series of general recommendations for all the patients with fi bromyalgia. However, in addition, for each subgroup, there are a series of specifi c pharmacological and psychological-type recommendations and those of modifi cation of the environment, which will make it possible to have a personalized approach to the patient with fi bromyalgia in accordance with their individual clinical characteristics (pain, catastrophizing levels, etc.).