International, multidisciplinary Delphi consensus recommendations on non-pharmacological interventions for fibromyalgia

Kundakci, Burak; Hall, Michelle; Atzeni, Fabiola; Branco, Jaime C.; Buskila, Dan; Clauw, Daniel; Crofford, Leslie J.; Fitzcharles, Mary Ann; Georgopoulos, Vasileios; Gerwin, Robert D.; Kosek, Eva; Macfarlane, Gary J.; Neal, Caroline; Rudin, Nathan J.; Ryan, Sarah; da Silva, José AP; Taylor, Ann; Turk, Dennis C.; Whibley, Daniel; Doherty, Michael; Zhang, Weiya; Abhishek, Abhishek; Branco, Jaime; da Silva, José A.P.; Taylor, Ann M.

Abstract

Objectives: To develop evidence-based expert recommendations for non-pharmacological treatments for pain, fatigue, sleep problems, and depression in fibromyalgia. Methods: An international, multidisciplinary Delphi exercise was conducted. Authors of EULAR and the Canadian Fibromyalgia Guidelines Group, members of the American Pain Society and clinicians with expertise in fibromyalgia were invited. Participants were asked to select non-pharmacological interventions that could be offered for specific fibromyalgia symptoms and to classify them as either core or adjunctive treatments. An evidence summary was provided to aid the decision making. Items receiving >70% votes were accepted, those receiving <30% votes were rejected and those obtaining 30-70% votes were recirculated for up to two additional rounds. Results: Seventeen experts participated (Europe (n = 10), North America (n = 6), and Israel (n = 1)) in the Delphi exercise and completed all three rounds. Aerobic exercise, education, sleep hygiene and cognitive behavioural therapy were recommended as core treatments for all symptoms. Mind-body exercises were recommended as core interventions for pain, fatigue and sleep problems. Mindfulness was voted core treatment for depression, and adjunctive treatment for other symptoms. Other interventions, namely music, relaxation, hot bath, and local heat were voted as adjunctive treatments, varying between symptoms. Conclusions: This study provided evidence-based expert consensus recommendations on non-pharmacological treatments for fibromyalgia that may be used to individualise treatments in clinical practice targeting the diverse symptoms associated with fibromyalgia.

Citation

Kundakci, B., Hall, M., Atzeni, F., Branco, J. C., Buskila, D., Clauw, D., …Taylor, A. M. (2022). International, multidisciplinary Delphi consensus recommendations on non-pharmacological interventions for fibromyalgia. Seminars in Arthritis and Rheumatism, 57, Article 152101. https://doi.org/10.1016/j.semarthrit.2022.152101

• Journal Article Type: Article
• Acceptance Date: Sep 22, 2022
• Online Publication Date: Sep 29, 2022
• Publication Date: 2022-12
• Deposit Date: Oct 19, 2022
• Publicly Available Date: Oct 21, 2022
• Journal: Seminars in Arthritis and Rheumatism
• Print ISSN: 0049-0172
• Electronic ISSN: 1532-866X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 57
• Article Number: 152101
• DOI: https://doi.org/10.1016/j.semarthrit.2022.152101
• Keywords: Anesthesiology and Pain Medicine; Rheumatology
• Public URL: https://nottingham-repository.worktribe.com/output/12022100
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0049017222001524?via%3Dihub