Differences in Multidisciplinary and Interdisciplinary Treatment Programs for Fibromyalgia: A Mapping Review

Abstract

Fibromyalgia is a multifaceted chronic pain syndrome and the integration of different health disciplines is strongly recommended for its care. The interventions based on this principle are very heterogeneous and the difference across their structures has not been extensively studied, leading to incorrect conclusions when their outcomes are pooled. The objective of this mapping review was to summarize the characteristics of these programs, with particular focus on the integration of their components. We performed a search of the literature about treatments for fibromyalgia involving multiple disciplines on PubMed and Scopus. Starting from 560 articles, we included 22 noncontrolled studies, 10 controlled studies, and 17 RCTs evaluating the effects of 38 multidisciplinary or interdisciplinary interventions. The average quality of the studies was low. Their outcomes were usually pain intensity, quality of life, and psychological variables. We created a map of the programs based on the degree of integration of the included disciplines, which ranged from a juxtaposition of few components to a complex harmonization of different perspectives obtained through teamwork strategies. The rehabilitation programs were then thoroughly described with regard to the duration, setting, therapeutic components, and professionals included. The implications for future quantitative reviews are discussed.

How Have Chronic Pain Management Programs Progressed? A Mapping Review

“…Although there was a gradual increase in the number of programs classified as interdisciplinary, the majority were still classified as multidisciplinary even in the 2010s. These findings are similar to a mapping review on PMPs for fibromyalgia, which reported twice as many programs using a multidisciplinary approach as interdisciplinary . Similarly, a qualitative study on teamwork structure of inpatient multidisciplinary programs for chronic musculoskeletal disorders found a continuum of practices across multi‐, inter‐, and trans‐disciplinary models.…”

Effectiveness, cost-utility, and benefits of a multicomponent therapy to improve the quality of life of patients with fibromyalgia in primary care

“…Some studies have shown clinical improvement with non-pharmacological therapies, particularly with exercise [14] and with cognitive-behavioral therapy (CBT). [15,16] There is also some evidence on the effectiveness of multicomponent group therapy, which involves patient education, exercise and CBT [17,18] , with reported clinical improvement that lasts 3 to 12 months after the intervention. [19,20] Interdisciplinary interventions conducted from hospitals [21–23] and PC [24–27] have obtained similar positive results.…”

Methods and Effectiveness of Communication Between Hospital Allied Health and Primary Care Practitioners: a Systematic Narrative Review

“…While important to collaboration, there has been little recognition of the role of hospital allied health professionals from the perspective of primary care practitioners. Although the terms 'multidisciplinary' and 'interdisciplinary' are often used interchangeably to denote a healthcare team working together, it has been suggested that the terms are conceptually different, with only the latter allowing the coordination of a common and coherent approach to care [64] required for collaboration [46]. The teams mentioned in the included studies were comprised of various healthcare professionals, acknowledged at times to be poorly described, with some relying on a social worker as the only hospital allied health representative mentioned.…”