Fibromyalgia in adults: Diagnostic process and treatment strategy

Background

The Haute Autorité de santé (French National Authority for Health) provides healthcare professionals supporting adult patients with a good practice guideline relating to the diagnostic process and treatment strategy for fibromyalgia.

Fibromyalgia is a disease recognised by the World Health Organization. Chronic, diffuse pain that is prolonged (lasting more than 3 months) is the main symptom. Often combined with other symptoms, it impairs physical capacities, the performance of activities of daily living and quality of life.

Requested by several patient associations, this clinical practice guideline follows on from the Syndrome fibromyalgique de l’adulte- Rapport d’orientation (has-sante.fr) guidance report for fibromyalgia syndrome in adults published by the HAS in 2010.

For the organisational aspects, the work was based on the care pathway guide for patients with chronic pain Parcours de santé d'une personne présentant une douleur chronique - Guide published by the HAS in 2023.

Challenges

The main challenge of this guideline is to help people with fibromyalgia live more easily with their pain, improving their understanding of both the symptoms and their impact, and how to get involved in their treatment. Another challenge is to prevent risks associated with ineffective or even dangerous practices.

Objectives

The objectives of this guideline are to define and improve the steps in the diagnostic process and to tailor the treatment strategy in order to provide patients with appropriate, scalable responses.

Professionals and persons concerned

This guideline is aimed at general practitioners, other specialists (rheumatologists, internal medicine specialists, neurologists, physical medicine and rehabilitation specialists, psychiatrists, pain specialists), chronic pain clinic resource physicians and nurses, preventive and occupational health service physicians and nurses, adapted physical activity professionals (in particular adapted physical activity trainers, physiotherapists), coordinated care nurses (including those working in team-based community services and advanced practice nurses), psychologists, pharmacists, dieticians, occupational therapists, psychomotor therapists, social workers, people with fibromyalgia and patient associations in the field concerned.

To help professionals assimilate this work

The HAS proposes:

• Recommendations.
• A summary of key messages to improve practices.
• Tools to aid diagnosis and scale the treatment strategy: self-administered questionnaire, criteria for diagnosis and monitoring of the severity of fibromyalgia, algorithms for the diagnostic process and scaled treatment strategy, information to be shared with the patient.
• Information document aimed at patients.