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

Area of Science:

• Rheumatology
• Pain Management
• Behavioral Medicine

Background:

• Fibromyalgia is a complex chronic condition characterized by widespread pain, fatigue, sleep disturbances, and mood disorders.
• Effective management often requires a multimodal approach, with a growing emphasis on non-pharmacological interventions.

Purpose of the Study:

• To establish evidence-based expert recommendations for non-pharmacological treatments for fibromyalgia symptoms.
• To guide clinicians in selecting appropriate interventions for pain, fatigue, sleep problems, and depression.

Main Methods:

• An international, multidisciplinary Delphi exercise involving 17 experts in fibromyalgia.
• Participants evaluated and classified non-pharmacological interventions as core or adjunctive treatments based on provided evidence summaries.
• A consensus was reached through three rounds of voting, with predefined criteria for acceptance, rejection, and recirculation of items.

Main Results:

• Aerobic exercise, education, sleep hygiene, and cognitive behavioral therapy were recommended as core treatments for all fibromyalgia symptoms.
• Mind-body exercises were endorsed as core interventions for pain, fatigue, and sleep problems.
• Mindfulness was identified as a core treatment for depression and an adjunctive treatment for other symptoms, with other therapies like relaxation and heat therapy also recommended as adjunctive.

Conclusions:

• This Delphi exercise yielded expert consensus on non-pharmacological strategies for managing fibromyalgia.
• The recommendations offer a framework for individualizing treatment plans to address the diverse symptom profile of fibromyalgia patients.
• These evidence-based guidelines can support clinicians in optimizing patient care through targeted non-pharmacological interventions.