Do patients with fibromyalgia syndrome receive updated management strategies? A web-based survey among Italian physiotherapists

Musculoskelet Sci Pract. 2024 Nov 30:75:103240. doi: 10.1016/j.msksp.2024.103240. Online ahead of print.

Abstract

Introduction: Fibromyalgia syndrome (FMS) causes significant pain, disability, and costs among patients. It is paramount that healthcare professionals have an updated knowledge of its characteristics and Clinical Practice Guidelines (CPGs).

Objectives: To determine the knowledge, adherence to CPGs, and confidence of Italian physiotherapists in managing patients with FMS, explore barriers to the implementation of CPG' recommendations, compare groups' adherence to CPGs, and determine which variables explained most of the participants' knowledge.

Methods: The survey was administered via social media and newsletter (i.e., Italian Association of Physiotherapists, AIFI) to Italian practicing physiotherapists. The protocol of this work was prospectively registered in the Open Science Framework.

Results: Total replies were 398. Italian physiotherapists showed a good knowledge of FMS and adherence to CPGs. Ninety-one percent reported a medium or lower confidence in managing patients with FMS. Sixty-seven percent judged their knowledge of CPGs as poor or very poor. The remaining 33% mentioned patients' psychosocial aspects, multidisciplinary relationships, and lack of training on communication strategies as the main barriers to the implementation of CPGs. Being an Orthopaedic Manipulative Physical Therapist (OMPT) resulted in a better adherence to CPGs on 11/14 items. Knowledge scores were correlated (r = 0.244) with being an OMPT (Stand β = 0.123) and years of professional activity (Stand β = -0.126).

Conclusions: Although Italian physiotherapists demonstrated a good knowledge of FMS and reported a good adherence to CPGs' recommendations, they may still experience barriers to the implementation of evidence-based management strategies.

Keywords: Fibromyalgia; Guidelines; Physiotherapy; Rehabilitation; Survey.