title: Interdisciplinary consensus document for the treatment of fibromyalgia.
abstract: Backgrounds. The elevated prevalence and enormous clinical and social impact of fibromyalgia, 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 fibromyalgia 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 specific 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 classifications proposed in fibromyalgia and the scientific evidence of the treatments used in this disease were reviewed. For the selection of the classification used and performance of the therapeutic recommendations, some of the usual techniques to obtain the consensus (nominal group and brainstorming) were used.Conclusion. The classification of Giesecke of fibromyalgia into 3 subgroups seems to have the greatest scientific evidence and the most useful for the clinician. The guide offers a series of general recommendations for all the patients with fibromyalgia. However, in addition, for each subgroup, there are a series of specific pharmacological and psychological-type recommendations and those of modification of the environment, which will make it possible to have a personalized approach to the patient with fibromyalgia in accordance with their individual clinical characteristics (pain, catastrophizing levels, etc.).
authors.affiliation: Jefe de Servicio de ReumatologíaHospital Universitari Val d’HebrónBarcelona, Spain.
authors.forename: C Alegre
authors.initials: CA
authors.lastname: de Miquel
authors.forename: J  García
authors.initials: J
authors.lastname: Campayo
authors.forename: M Tomás
authors.initials: MT
authors.lastname: Flórez
authors.forename: J M  Gómez
authors.initials: JM
authors.lastname: Arguelles
authors.forename: E Blanco
authors.initials: EB
authors.lastname: Tarrio
authors.forename: M Gobbo
authors.initials: MG
authors.lastname: Montoya
authors.forename: Á  Pérez
authors.initials: Á
authors.lastname: Martin
authors.forename: A Martínez
authors.initials: AM
authors.lastname: Salio
authors.forename: J Vidal
authors.initials: JV
authors.lastname: Fuentes
authors.forename: E Altarriba
authors.initials: EA
authors.lastname: Alberch
authors.forename: A Gómez
authors.initials: AG
authors.lastname: de la Cámara
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005356:Fibromyalgia / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D010353:Patient Education as Topic; D010358:Patient Participation; D011788:Quality of Life
chemical_list: D000928:Antidepressive Agents