Toward a Transdisciplinary Integration of the Health Disciplines: The Case of the Fibromyalgia Syndrome
Keywords:
Fibromyalgia; interdisciplinary; transdisciplinary; patient care
Abstract
DOI: https://doi.org/10.1515/pepsi-2017-0008
Fibromyalgia is a chronic pain disorder with a multifaceted nature and its biological, psychological and social aspects are strongly interconnected. Therefore, the integration of the different health disciplines is strongly recommended for its care. There is a growing number of interventions based on this principle but each of them is heterogeneous with regards to how the included disciplines are integrated with each other. With this regards, multidisciplinary and interdisciplinary programs are distinguished. The former are organized in order to treat the various aspects of the syndrome using different perspectives and their various treatment components are usually provided separately by the different care providers. Conversely, interdisciplinary treatments are planned in order to foster a dialogue between the operators by providing a joint conduction of the treatment or scheduling plenary discussions about the cases. In the field of chronic pain, some authors are suggesting to move beyond these approaches and to plan transdisciplinary treatments, which would allow the professionals to move across their disciplinary boundaries. Although no examples of these interventions have been proposed for the treatment of fibromyalgia, there is a visible trend in the literature toward more holistic forms of care.
References
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Lemstra, M., & Olszynski, W. P. (2005). The effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia: A randomized controlled trial. “Clinical Journal of Pain”, Vol. 21, Issue 2, pp. 166-174, DOI:10.1097/00002508-200503000-00008.
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Mannerkorpi, K. (2005). Exercise in fibromyalgia. “Current Opinion in Rheumatology”, Vol. 17, Issue 2, pp. 190-194,
Martín, J., Torre, F., Aguirre, U., González, N., Padierna, A., Matellanes, B., & Quintana, J. M. S. O. S. C. (2014). Evaluation of the interdisciplinary PSYMEPHY treatment on patients with fibromyalgia: A randomized control trial. “Pain Medicine”, Vol. 15, Issue 4, pp. 682-691, DOI:10.1111/pme.12375.
Meeus, M., & Nijs, J. (2007). Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. “Clinical Rheumatology”, Vol. 26, Issue 4, pp. 465-473, DOI:10.1007/s10067-006-0433-9.
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Turk, D. C., Okifuji, A., Sinclair, J. D., & Starz, T. W. (1998). Interdisciplinary treatment for fibromyalgia syndrome: Clinical and statistical signifi cance. “Arthritis Care and Research”, Vol. 11, Issue 3, pp. 186-195,
Van Abbema, R., Van Wilgen, C. P., Van Der Schans, C. P., & Van Ittersum, M. W. (2011). Patients with more severe symptoms benefit the most from an intensive multimodal programme in patients with fibromyalgia. “Disability and Rehabilitation”, Vol. 33, Issue 9, pp. 743-750, DOI:10.3109/09638288.2010.510177.
Van Eijk-Hustings, Y., Kroese, M., Tan, F., Boonen, A., Bessems-Beks, M., & Landewé, R. (2013). Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: A randomised controlled trial. “Clinical Rheumatology”, Vol. 32, Issue 2, pp. 199-209, DOI:10.1007/s10067-012-2100-7.
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Amris, K., Waehrens, E. E., Christensen, R., Bliddal, H., & Danneskiold-Samsoe, B. (2014). Interdisciplinary rehabilitation of patients with chronic widespread pain: primary endpoint of the randomized, nonblinded, parallel-group IMPROvE trial. “Pain”, Vol. 155, Issue 7, pp. 1356-1364, DOI:10.1016/j.pain.2014.04.012.
Anderson, F. J., & Winkler, A. E. (2006). Benefi ts of long-term fibromyalgia syndrome treatment with a multidisciplinary program. “Journal of Musculoskeletal Pain”, Vol. 14, Issue 4, pp. 11-25, DOI:10.1300/J094v14n04_03.
Andrell, P., Schultz, T., Mannerkorpi, K., Nordeman, L., Borjesson, M., & Mannheimer, C. (2014). Health-related quality of life in fibromyalgia and refractory angina pectoris: a comparison between two chronic non-malignant pain disorders. “Journal of Rehabilitation Medicine”, Vol. 46, Issue 4, pp. 341-347, DOI:10.2340/16501977-1279.
Angst, F., Brioschi, R., Main, C. J., Lehmann, S., & Aeschlimann, A. (2006). Interdisciplinary Rehabilitation in Fibromyalgia and Chronic Back Pain: A Prospective Outcome Study. “Journal of Pain”, Vol. 7, Issue 11, pp. 807-815, DOI:10.1016/j.jpain.2006.03.009.
Angst, F., Verra, M. L., Lehmann, S., Brioschi, R., & Aeschlimann, A. (2009). Clinical effectiveness of an interdisciplinary pain management programme compared with standard inpatient rehabilitation in chronic pain: A naturalistic, prospective controlled cohort study. “Journal of Rehabilitation Medicine”, Vol. 41, Issue 7, pp. 569-575, DOI:10.2340/16501977-0381.
Armentor, J. L. (2015). Living With a Contested, Stigmatized Illness: Experiences of Managing Relationships Among Women With Fibromyalgia. “Qual Health Res”, DOI:10.1177/1049732315620160.
Blehm, R. (2006). Physical therapy and other nonpharmacologic approaches to fibromyalgia management. “Current Pain and Headache Reports”, Vol. 10, Issue 5, pp. 333-338,
Buskila, D. (2003). Fibromyalgia: a biopsychosocial syndrome. “Israel Medical Association Journal”, Vol. 5, Issue 12, pp. 887-888,
Cagnie, B., Coppieters, I., Denecker, S., Six, J., Danneels, L., & Meeus, M. (2014). Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI. “Seminars in Arthritis and Rheumatism”, Vol. 44, Issue 1, pp. 68-75, DOI:10.1016/j.semarthrit.2014.01.001.
Carbonell-Baeza, A., Aparicio, V. A., Ortega, F. B., Cuevas, A. M., Alvarez, I. C., Ruiz, J. R., & Delgado-Fernandez, M. (2011). Does a 3-month multidisciplinary intervention improve pain, body composition and physical fitness in women with fibromyalgia? “British Journal of Sports Medicine”, Vol. 45, Issue 15, pp. 1189-1195, DOI:10.1136/bjsm.2009.070896.
Carter, J. J., Zawalski, S., Sminkey, P. V., & Christopherson, B. (2015). Assessing the whole person: case managers take a holistic approach to physical and mental health. “Professional Case Management”, Vol. 20, Issue 3, pp. 140-146, DOI:10.1097/NCM.0000000000000087.
Cartmill, C., Soklaridis, S., & David Cassidy, J. (2011). Transdisciplinary teamwork: the experience of clinicians at a functional restoration program. “Journal of Occupational Rehabilitation”, Vol. 21, Issue 1, pp. 1-8, DOI:10.1007/s10926-010-9247-3.
Castelnuovo, G., Giusti, E. M., Manzoni, G. M., Saviola, D., Gatti, A., Gabrielli, S.,... Tamburin, S. (2016a). Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation. “Front Psychol”, Vol. 7, pp. 468, DOI:10.3389/fpsyg.2016.00468.
Castelnuovo, G., Giusti, E. M., Manzoni, G. M., Saviola, D., Gatti, A., Gabrielli, S., Tamburin, S. (2016b). Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation. “Front Psychol”, Vol. 7, pp. 115, DOI:10.3389/fpsyg.2016.00115.
Choi, B. C., & Pak, A. W. (2006). Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Defi nitions, objectives, and evidence of effectiveness. “Clinical and Investigative Medicine”, Vol. 29, Issue 6, pp. 351-364,
Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. “Science”, Vol. 196, Issue 4286, pp. 129-136,
Goldenberg, D. L. (1987). Fibromyalgia syndrome: An emerging but controversial condition. “JAMA”, Vol. 257, Issue 20, pp. 2782-2787, DOI:10.1001/jama.1987.03390200122026.
Gordon, R. M., Corcoran, J. R., Bartley-Daniele, P., Sklenar, D., Sutton, P. R., & Cartwright, F. (2014). A transdisciplinary team approach to pain management in inpatient health care settings. “Pain Management Nursing”, Vol. 15, Issue 1, pp. 426-435, DOI:10.1016/j.pmn.2013.01.004.
Guymer, E. K., Maruff, P., & Littlejohn, G. O. (2012). Clinical characteristics of 150 consecutive fibromyalgia patients attending an Australian public hospital clinic. “International Journal of Rheumatic Diseases”, Vol. 15, Issue 4, pp. 348-357, DOI:10.1111/j.1756-185X.2012.01767.x.
Hauser, W., Arnold, B., Eich, W., Felde, E., Flugge, C., Henningsen, P., Kopp, I. (2008). Management of fibromyalgia syndrome--an interdisciplinary evidencebased guideline. “German Medical Science”, Vol. 6, pp. Doc14,
Inanici, F., & Yunus, M. B. (2004). History of fibromyalgia: past to present. “Current Pain and Headache Reports”, Vol. 8, Issue 5, pp. 369-378,
Lemstra, M., & Olszynski, W. P. (2005). The effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia: A randomized controlled trial. “Clinical Journal of Pain”, Vol. 21, Issue 2, pp. 166-174, DOI:10.1097/00002508-200503000-00008.
Longley, K. (2006). Fibromyalgia: aetiology, diagnosis, symptoms and management. “British Journal of Nursing”, Vol. 15, Issue 13, pp. 729-733, DOI:10.12968/bjon.2006.15.13.21487.
Macfarlane, G. J., Kronisch, C., Dean, L. E., Atzeni, F., Hauser, W., Fluss, E., Jones, G. T. (2016). EULAR revised recommendations for the management of fibromyalgia. “Annals of the Rheumatic Diseases”, DOI:10.1136/annrheumdis-2016-209724.
Mannerkorpi, K. (2005). Exercise in fibromyalgia. “Current Opinion in Rheumatology”, Vol. 17, Issue 2, pp. 190-194,
Martín, J., Torre, F., Aguirre, U., González, N., Padierna, A., Matellanes, B., & Quintana, J. M. S. O. S. C. (2014). Evaluation of the interdisciplinary PSYMEPHY treatment on patients with fibromyalgia: A randomized control trial. “Pain Medicine”, Vol. 15, Issue 4, pp. 682-691, DOI:10.1111/pme.12375.
Meeus, M., & Nijs, J. (2007). Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. “Clinical Rheumatology”, Vol. 26, Issue 4, pp. 465-473, DOI:10.1007/s10067-006-0433-9.
Offenbaecher, M., Bondy, B., de Jonge, S., Glatzeder, K., Kruger, M., Schoeps, P., & Ackenheil, M. (1999). Possible association of fibromyalgia with a polymorphism in the serotonin transporter gene regulatory region. “Arthritis & Rheumatology”, Vol. 42, Issue 11, pp. 2482-2488, DOI:10.1002/1529-0131.
Ong, K. S., & Keng, S. B. (2003). The biological, social, and psychological relationship between depression and chronic pain. “Cranio”, Vol. 21, Issue 4, pp. 286-294,
Papadopoulou, D., Fassoulaki, A., Tsoulas, C., Siafaka, I., & Vadalouca, A. (2016). A meta-analysis to determine the effect of pharmacological and non-pharmacological treatments on fibromyalgia symptoms comprising OMERACT-10 response criteria. “Clinical Rheumatology”, Vol. 35, Issue 3, pp. 573-586, DOI:10.1007/s10067-015-3144-2.
Perrot, S. (2014). What can fibromyalgia teach us about chronic pain? An emblematic condition to discuss mind and body concepts, predictive medicine and assessment of chronic condition management. “European Journal of Pain”, Vol. 18, Issue 8, pp. 1049-1051, DOI:10.1002/ejp.557.
Rivera, J., & Vallejo, M. A. (2016). Fibromyalgia is associated to receiving chronic medications beyond appropriateness: a cross-sectional study. “Rheumatology International”, DOI:10.1007/s00296-016-3568-2.
Ryan, S. (2011). Fibromyalgia: an overview and comparison of treatment options. “British Journal of Nursing”, Vol. 20, Issue 16, pp. 991-992, 994-995, DOI:10.12968/bjon.2011.20.16.991.
Scascighini, L., Toma, V., Dober-Spielmann, S., & Sprott, H. (2008). Multidisciplinary treatment for chronic pain: A systematic review of interventions and outcomes. “Rheumatology”, Vol. 47, Issue 5, pp. 670-678, DOI:10.1093/rheumatology/ken021.
Turk, D. C., & Adams, L. M. (2016). Using a biopsychosocial perspective in the treatment of fibromyalgia patients. “Pain Manag”, Vol. 6, Issue 4, pp. 357-369, DOI:10.2217/pmt-2016-0003.
Turk, D. C., Okifuji, A., Sinclair, J. D., & Starz, T. W. (1998). Interdisciplinary treatment for fibromyalgia syndrome: Clinical and statistical signifi cance. “Arthritis Care and Research”, Vol. 11, Issue 3, pp. 186-195,
Van Abbema, R., Van Wilgen, C. P., Van Der Schans, C. P., & Van Ittersum, M. W. (2011). Patients with more severe symptoms benefit the most from an intensive multimodal programme in patients with fibromyalgia. “Disability and Rehabilitation”, Vol. 33, Issue 9, pp. 743-750, DOI:10.3109/09638288.2010.510177.
Van Eijk-Hustings, Y., Kroese, M., Tan, F., Boonen, A., Bessems-Beks, M., & Landewé, R. (2013). Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: A randomised controlled trial. “Clinical Rheumatology”, Vol. 32, Issue 2, pp. 199-209, DOI:10.1007/s10067-012-2100-7.
Van Koulil, S., Van Lankveld, W., Kraaimaat, F. W., Van Helmond, T., Vedder, A., Van Hoorn, H., ... Evers, A. W. M. (2011). Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia. “Annals of the Rheumatic Diseases”, Vol. 70, Issue 12, pp. 2131-2133, DOI:10.1136/ard.2010.148577.
