Clauw Daniel J, D'Arcy Yvonne, Gebke Kevin, Semel David, Pauer Lynne, Jones Kim D
a Department of Anesthesiology , University of Michigan , Ann Arbor , MI , USA.
b Pain Management Nurse Practitioner , Ponte Vedra Beach , FL , USA.
Postgrad Med. 2018 Jan;130(1):9-18. doi: 10.1080/00325481.2018.1411743. Epub 2017 Dec 19.
Fibromyalgia (FM) is a complex chronic disease that affects 3-10% of the general adult population and is principally characterized by widespread pain, and is often associated with disrupted sleep, fatigue, and comorbidities, among other symptoms. There are many gaps in our knowledge of FM, such that, compared with other chronic illnesses including diabetes, rheumatoid arthritis, and asthma, it is far behind in terms of provider understanding and therapeutic approaches. The experience that healthcare professionals (HCPs) historically gained in developing approaches to manage and treat patients with these chronic illnesses may help show how they can address similar problems in patients with FM. In this review, we examine some of the issues around the management and treatment of FM, and discuss how HCPs can implement appropriate strategies for the benefit of patients with FM. These issues include understanding that FM is a legitimate condition, the benefits of prompt diagnosis, use of non-drug and pharmacotherapies, patient and HCP education, watchful waiting, and assessing patients by FM domain so as not to focus exclusively on one symptom to the detriment of others. Developing successful approaches is of particular importance for HCPs in the primary care setting who are in the ideal position to provide long-term care for patients with FM. In this way, FM may be normalized as a chronic illness to the benefit of both patients and HCPs.
纤维肌痛(FM)是一种复杂的慢性疾病,影响着3%至10%的成年普通人群,其主要特征是广泛疼痛,常伴有睡眠障碍、疲劳和共病等其他症状。我们对纤维肌痛的了解存在许多空白,因此,与包括糖尿病、类风湿性关节炎和哮喘在内的其他慢性疾病相比,在医疗服务提供者的理解和治疗方法方面,纤维肌痛远远落后。医疗保健专业人员(HCPs)在历史上积累的开发管理和治疗这些慢性疾病患者方法的经验,可能有助于展示他们如何解决纤维肌痛患者的类似问题。在本综述中,我们研究了纤维肌痛管理和治疗的一些问题,并讨论了医疗保健专业人员如何为纤维肌痛患者实施适当策略以使其受益。这些问题包括认识到纤维肌痛是一种合理的病症、及时诊断的益处、非药物和药物治疗的使用、患者和医疗保健专业人员教育、密切观察等待,以及按纤维肌痛领域评估患者,以免只专注于一种症状而损害其他症状。对于基层医疗环境中的医疗保健专业人员来说,开发成功的方法尤为重要,他们处于为纤维肌痛患者提供长期护理的理想位置。通过这种方式,纤维肌痛作为一种慢性疾病可以正常化,这对患者和医疗保健专业人员都有益。