JMIR Publications

ABSTRACT

Background:

Fibromyalgia is a prevalent musculoskeletal condition that incurs significant personal, social, and societal costs. Self-management, particularly in the areas of lifestyle, physical activity and in the cognitive and mental areas, plays an important role in fibromyalgia as pharmacological treatments often are not effective. Digital health applications are increasingly recognized as point-of-care to deliver and coordinate self-management programs to patients. However, the therapeutic content they offer is often inconsistent, lacks transparency, and may not be evidence-based.

Objective:

To elaborate an online self-management program for fibromyalgia patients based on current evidence and to explore optimization strategies.

Methods:

PubMed and Cochrane databases were searched for guidelines and systematic reviews of randomized controlled trials on self-management interventions for adults diagnosed with fibromyalgia or other nociplastic pain conditions. The AGREE II – GRS or the AMSTAR 2 tools were used to assess the selected studies. Self-management interventions considered had to be adaptable to a mobile application.

Results:

Thirty systematic reviews and eight guidelines were included in the analysis. Three categories of self-management interventions for fibromyalgia emerged: 1. Physical activity 2. Psycho-education and 3. Mind-Body exercises. While flexibility exercises did not demonstrate significant benefits, aerobic and resistance exercises showed potential in reducing fibromyalgia symptoms. Psycho-educative interventions, such as cognitive-behavioural therapies and educational intervention, are also considered to improve fibromyalgia symptoms. Mind-body therapies had mixed effects, with meditative movement therapies like Qi Gong, Tai Chi, and Yoga showing benefits, while meditation, hypnosis, and relaxation did not exhibit significant efficacy. Psycho-educative therapies in form of cognitive behaviour therapy (CBT) followed by physical exercise instructions were considered as the most suitable evidence-based content to be integrated in mobile health applications.

Conclusions:

Effective mHealth self-management programs for fibromyalgia patients should consist of tailored multicomponent interventions with proven evidence. Psycho-educative and physical activity interventions appear to be most adaptable for the integration in mobile health applications.