Fibromyalgia (Canada)

Top 10 priorities

1. Can early targeted/personalised treatment plans based on sub-grouping and/or staging of severity improve outcome for people living with fibromyalgia?
2. What evidence is there to support the use of lifestyle interventions (i.e. nutrition, exercise, take more breaks, general lifestyle interventions) for the management of fibromyalgia symptoms?
3. What are the best ways to manage sleep problems in people living with fibromyalgia?
4. What are the effective methods for educating patients living with fibromyalgia to take an active role in their care?
5. What are the health care settings for persons with fibromyalgia that would allow for the best health care professional and optimal care pathway, and for appropriate follow-up?
6. What innovative self-management strategies, including social media and on-line tools, may be used in fibromyalgia care and do they impact outcome?
7. What are the best methods to treat and manage cognitive symptoms of fibromyalgia?
8. How safe and effective is the use of cannabinoids and opioids in treating fibromyalgia?
9. Does improving patient health literacy (i.e. education on medications, neuroscience of pain mechanism) help improve patient health outcomes in people with fibromyalgia?
10. What is the most effective treatment for hypersensitivity (e.g. touch, noise, odour, light, hypervigilance) in fibromyalgia patients?

The following questions were also discussed and put in order of priority at the workshop:

11. To what extent does physical environment (i.e. living/working space) affect fibromyalgia symptoms and influence disease management?
12. By what methods can a health care professional safely and effectively wean a person with fibromyalgia off a medication?
13. How prevalent is polypharmacy (or simultaneous use of multiple medications to treat a single condition) in fibromyalgia patients and are lower doses of more drugs better than high doses of fewer drugs?
14. What are effective methods in educating health care professionals to reduce the stigma that patients living with fibromyalgia experience?
15. How does fibromyalgia impact patients’ concurrent medical conditions (e.g. diabetes, arthritis, cancer, myalgic encephalomyelitis) and vice versa? (i.e. diagnosis of new conditions, treatment of concurrent conditions, symptoms, success of treatment)
16. What workplace accommodations can be made to best allow people with fibromyalgia to continue working and manage their disease symptoms throughout the life course?
17. What factors (e.g. personality, socio-economic status, type of program, type of treatment) affect adherence to treatments for people living with fibromyalgia?
18. How effective are different medications including drugs given by novel routes of administration (injection, topical, mucosal) in fibromyalgia patients and how do they affect quality of life and ability to work?
19. What community-based resources would be effective methods of disease management for people with fibromyalgia (e.g. support groups, health literacy coaches)
20. What are effective methods in educating the public (i.e. family, friends, co-workers, employers to reduce the stigma that patients living with fibromyalgia experience?
21. Can a treatment algorithm or guidelines recommending the best treatment for symptoms be developed for people living with fibromyalgia?
22. Can the benefits of medication be maintained after the medication has been withdrawn from the patient’s treatment?
23. How can people living with fibromyalgia be screened and managed to detect risk for addictions and prevent the development of outcomes such as medication misuse.