Der Schmerz

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Allgemeine Behandlungsgrundsätze, Versorgungskoordination und Patientenschulung beim Fibromyalgiesyndrom und chronischen Schmerzen in mehreren Körperregionen

  • A. Klement
  • W. Häuser
  • W. Brückle
  • U. Eidmann
  • E. Felde
  • M. Herrmann
  • H. Kühn-Becker
  • M. Offenbächer
  • M. Settan
  • M. Schiltenwolf
  • M. von Wachter
  • W. Eich
Schwerpunkt

Zusammenfassung

Hintergrund

Eine interdisziplinäre Leitlinie zur Therapie des Fibromyalgiesyndroms (FMS) wurde in Kooperation von 10 medizinischen bzw. psychologischen Fachgesellschaften und 2 Patientenselbsthilfeorganisationen erstellt.

Methodik

Eine Literatursuche über alle kontrollierten Studien zur Patientenschulung des FMS wurde unter Benutzung der Cochrane Collaboration Reviews (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) und Scopus (1980–12/2006) durchgeführt. Für die Vergabe von Evidenzklassen wurde das System des Oxford Centre for Evidence-Based Medicine verwendet. Für die Vergabe von Empfehlungsgraden wurde die Empfehlungsgraduierung der nationalen Versorgungsleitlinien verwendet. Die Erstellung der Empfehlungen erfolgte in einem mehrstufigen nominalen Gruppenprozess.

Ergebnisse

Den Empfehlungsgrad A erhielten die Patienteninformation bei Erstdiagnose und Empfehlungsgrad B die ärztliche patientenzentrierte Kommunikation. Ein abgestuftes Behandlungskonzept in Abhängigkeit vom Ausmaß der Adaptation an Beeinträchtigungen von Alltagsfunktionen sowie Ansprechen auf Therapiemaßnahmen erhielt den Empfehlungsgrad C.

Schlussfolgerung

Die Langzeitbetreuung von FMS-Patienten sollte Grundsätze der psychosomatischen Grundversorgung und der gemeinsamen Entscheidungsfindung bzgl. der Therapieoptionen beinhalten.

Schlüsselwörter

Fibromyalgiesyndrom (FMS) Leitlinie Patientenschulung Patientenzentrierte Kommunikation Abgestuftes Therapiekonzept 

Principles of treatment, coordination of medical care and patient education in fibromyalgia syndrome and chronic widespread pain

Abstract

Background

A guideline for the treatment and diagnostic procedures for fibromyalgia syndrome (FMS) was developed in cooperation with 10 German medical and psychological associations and 2 patient self-help groups.

Methods

A systematic literature search including all controlled studies evaluating physiotherapy, exercise and strength training as well as physical therapies was performed in the Cochrane Collaboration Reviews (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) and Scopus (1980–12/2006). Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures to reach a consensus on recommendations were used.

Results

Patient’s information at first diagnosis of FMS is strongly recommended (grade A). Patient-centered communication is recommended (grade B). A stepwise treatment approach depending on the adapatation to restrictions in daily life and response to treatment options can be considered (grade C).

Conclusions

The long-term treatment should be based on principles of basic psychosomatic care and shared decision making on treatment options.

Keywords

Fibromyalgia syndrome (FMS) Guideline Patient education Patient-centered communication Stepwise treatment approach 

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Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  • A. Klement
    • 1
  • W. Häuser
    • 2
  • W. Brückle
    • 3
  • U. Eidmann
    • 4
  • E. Felde
    • 5
  • M. Herrmann
    • 1
    • 11
  • H. Kühn-Becker
    • 6
  • M. Offenbächer
    • 7
  • M. Settan
    • 5
  • M. Schiltenwolf
    • 8
  • M. von Wachter
    • 9
  • W. Eich
    • 10
  1. 1.Institut für AllgemeinmedizinMartin-Luther-Universität Halle-WittenbergHalleDeutschland
  2. 2.Zentrum für SchmerztherapieKlinikum Saarbrücken gGmbHSaarbrückenDeutschland
  3. 3.Rheumaklinik Bad NenndorfBad NenndorfDeutschland
  4. 4.Deutsche Rheuma-LigaBonnDeutschland
  5. 5.Deutsche Fibromyalgie VereinigungSeckachDeutschland
  6. 6.Praxis für Anästhesiologie, Spezielle Schmerztherapie und PsychotherapieZweibrückenDeutschland
  7. 7.Generation Research Program, Humanwissenschaftliches Zentrum, Bad TölzLudwig-Maximilians-Universität MünchenBad TölzDeutschland
  8. 8.Sektion SchmerztherapieStiftung Orthopädische Universitätsklinik HeidelbergHeidelbergDeutschland
  9. 9.Klinik für PsychosomatikOstalb-Klinikum AalenAalenDeutschland
  10. 10.Abteilung Innere Medizin II (Allgemeine Klinische und Psychosomatische Medizin)Universitätsklinikum HeidelbergHeidelbergDeutschland
  11. 11.Institut für AllgemeinmedizinOtto-von-Guericke-UniversitätMagdeburgDeutschland

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