Explaining a diagnosis of fibromyalgia in primary care: a scoping review

Abstract

Background: Fibromyalgia is a common cause of chronic pain in the UK, with a huge individual and societal impact. Despite this, it remains difficult to diagnose and treat. The explanation of a fibromyalgia diagnosis can lead to difficult therapeutic relationships, with attitudinal issues and negative profiling of patients. This can lead to frustration, and have a harmful impact on health outcomes.

Aim: To review how an explanation of a fibromyalgia diagnosis is provided in primary care in order to establish a model of best practice when educating patients on their diagnosis.

Design & setting: Scoping review of articles written in English.

Method: MEDLINE, Embase, Web of Science, and grey literature were searched. Articles were extracted, reviewed, and analysed according to the inclusion criteria.

Results: In total, 29 records met the inclusion criteria. The following six overarching themes were identified: patient education; physician education; importance of the multidisciplinary team; importance of patient-centred care; the value of primary care; and useful resources. The literature illustrated that describing fibromyalgia using analogies to illustrate the pain sensitisation process can help patients understand their diagnosis better. This improves their willingness to accept management plans, particularly engagement with non-pharmacological therapies, which the literature suggested are best delivered within a multidisciplinary team.

Conclusion: Key aspects of fibromyalgia should be explained to patients in order for them to gain a better understanding of their diagnosis. A 'one-size-fits-all' model for explaining the fibromyalgia diagnosis to patients is inappropriate because patients' experiences are individualised. Further research is required on whether different explanations impact patient outcomes.

Keywords: education; fibromyalgia; general practitioners; primary health care.

Figure 1.. PRISMA flow diagram

Figure 2.. Overview characteristics of the included publications. Countries in Europe from which included studies originate: 18 were from Italy, UK, Norway, Spain, and the Netherlands; ^{,–,–,–,,,} the 19th article was developed by a working group with authors from the UK, Switzerland, Italy, Germany, Sweden, Denmark, Portugal, Turkey, Finland, Republic of Ireland, Cyprus, and France.