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Das Fibromyalgiesyndrom

Allgemeine Behandlungsgrundsätze, Versorgungskoordination und Patientenschulung

Fibromyalgia syndrome

General principles and coordination of clinical care and patient education

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Zusammenfassung

Hintergrund

Die planmäßige Aktualisierung der S3-Leitlinie zum Fibromyalgiesyndrom (FMS; AWMF-Registernummer 041/004) wurde ab März 2011 vorgenommen.

Material und Methoden

Die Leitlinie wurde unter Koordination der Deutschen Interdisziplinären Vereinigung für Schmerztherapie (DIVS) von 9 wissenschaftlichen Fachgesellschaften und 2 Patientenselbsthilfeorganisationen entwickelt. Acht Arbeitsgruppen mit insgesamt 50 Mitgliedern wurden ausgewogen in Bezug auf Geschlecht, medizinischen Versorgungsbereich, potenzielle Interessenkonflikte und hierarchische Position im medizinischen bzw. wissenschaftlichen System besetzt.

Die Literaturrecherche erfolgte über die Datenbanken Medline, PsycInfo, Scopus und Cochrane Library (bis Dezember 2010). Die Graduierung der Evidenzstärke erfolgte nach dem Schema des Oxford Center for Evidence Based Medicine. Die Formulierung und Graduierung der Empfehlungen erfolgte in einem mehrstufigen, formalisierten Konsensusverfahren. Die Leitlinie wurde von den Vorständen der beteiligten Fachgesellschaften begutachtet.

Ergebnisse und Schlussfolgerung

Die Diagnose eines FMS soll dem Betroffenen explizit mitgeteilt werden. Eine stufenweise Behandlung in Abhängigkeit vom Schweregrad des FMS und dem Ansprechen auf Therapiemaßnahmen wird empfohlen. Therapien sollen nur fortgeführt werden, wenn die positiven Wirkungen die Nebenwirkungen überwiegen.

Abstract

Background

The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies (“Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften”, AWMF; registration number 041/004) was planned starting in March 2011.

Materials and methods

The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy (“Deutsche Interdisziplinären Vereinigung für Schmerztherapie”, DIVS), 9 scientific medical societies and 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields.

Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). The grading of the strength of the evidence followed the scheme of the Oxford Centre for Evidence-Based Medicine. The formulation and grading of recommendations was accomplished using a multi-step, formal consensus process. The guidelines were reviewed by the boards of the participating scientific medical societies.

Results and conclusion

A diagnosis of FMS should be explicitly communicated with the afflicted individual. A step-wise treatment, depending on the severity of FMS and the responses to therapeutic measures, is recommended. Therapy should only be continued if the positive effects outweigh the side effects.

The English full-text version of this article is available at SpringerLink (under “Supplemental”).

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Interessenkonflikt

Siehe Tab. 5 im Beitrag „Methodenreport“ von W. Häuser, K. Bernardy, H. Wang, I. Kopp in dieser Ausgabe

Author information

Authors and Affiliations

  1. Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 10, 69210, Heidelberg, Deutschland

    W. Eich

  2. Innere Medizin 1, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland

    W. Häuser

  3. Abteilung für Schmerztherapie, Klinikum Dachau, Dachau, Deutschland

    B. Arnold

  4. Abteilung für Schmerztherapie, Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH, Ruhr-Universität Bochum, Bochum, Deutschland

    K. Bernardy

  5. Klinik Der Fürstenhof Bad Pyrmont, Bad Pyrmont, Deutschland

    W. Brückle

  6. Deutsche Rheuma-Liga, Wuppertal, Deutschland

    U. Eidmann

  7. Interdisziplinäres Schmerzzentrum, Fachklinik Enzensberg, Hopfen am See, Deutschland

    K. Klimczyk

  8. Fachklinik für Psychosomatische Medizin, MediClin Bliestal Kliniken, Blieskastel, Deutschland

    V. Köllner

  9. Schmerzzentrum Zweibrücken, Zweibrücken, Deutschland

    H. Kühn-Becker

  10. Humanwissenschaftliches Zentrum, Ludwig-Maximilians-Universität München, München, Deutschland

    M. Offenbächer

  11. Deutsche Fibromyalgie-Vereinigung, Seckach, Deutschland

    M. Settan

  12. Klinik für Psychosomatik, Ostalb-Klinikum Aalen, Aalen, Deutschland

    M. von Wachter

  13. Schmerz-Tagesklinik und -Ambulanz, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland

    F. Petzke

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  1. W. Eich
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Corresponding author

Correspondence to W. Eich.

Additional information

Die englische Volltextversion dieses Beitrags und der Evidenzbericht sind in SpringerLink zugänglich (unter „Supplemental“).

Zusatzmaterial online

482_2012_1167_MO1_ESM.pdf

English version of "Das Fibromyalgiesyndrom. Allgemeine Behandlungsgrundsätze, Versorgungskoordination und Patientenschulung" (PDF 0,3 MB)

482_2012_1167_MO2_ESM.pdf

Evidenzbericht: Forest Plots der standardisierten Mittelwertdifferenzen von experimenteller Gruppe versus Kontrollgruppe bei ausgewählten Zielvariablen am Therapieende und bei Nachuntersuchungen (PDF 0,4 MB)

482_2012_1167_MO3_ESM.pdf

Evidence report: Forest Plots of standardised mean differences between experimental groups versus controls on selected outcomes at final treatment and at follow up (PDF 0,4 MB)

482_2012_1167_MO4_ESM.pdf

Evidenzbericht: Tabellen - Charakteristiken der Studien, die in qualitative und/oder quantitative Analyse einbezogen wurden (PDF 0,3 MB)

482_2012_1167_MO5_ESM.pdf

Evidence report: Tables - Characteristics of studies included into qualitative and/or quantitative analysis (PDF 0,7 MB)

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Eich, W., Häuser, W., Arnold, B. et al. Das Fibromyalgiesyndrom. Schmerz 26, 268–275 (2012). https://doi.org/10.1007/s00482-012-1167-z

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