Challenges in adherence to treatment in patients with fibromyalgia

Abstract

Fibromyalgia (FM) is a non-articular rheumatic disease, a chronic and heterogeneous condition in which the patient has diffuse musculoskeletal pain, in addition to associated symptoms such as fatigue, sleep disorders, stiffness and a subjective sensation of swelling. FM is directly related to the loss of quality of life, therefore, the therapeutic objective is to provide comprehensive and comprehensive treatment. In the pharmacological management of FM, pregabalin and duloxetine are the pharmacological agents indicated by the Food and Drug Administration (FDA) to alleviate symptoms and improve the quality of life of patients with this chronic condition. The present study aims to identify the impact of adverse effects on adherence to pharmacological therapy in patients with FM, evaluating the types and frequencies of these effects and investigating the comparative efficacy of pregabalin and duloxetine in the context of treatment. An integrative literature review was carried out from the PubMed and BVS databases using Boolean descriptors and terms: Fibromyalgia AND Treatment AND Adverse Effects AND Adherence. Twenty-two full articles published from 2019 to 2024 were included. The results indicate that pregabalin was associated with blurred vision, cognitive effects, sedation and weight gain, while duloxetine, in turn, has adverse effects such as insomnia, constipation, dizziness and headache and, more rarely, acid reflux. These effects often make it difficult and can lead to treatment abandonment. We detected that treatment adherence is often compromised due to the variety of adverse effects that impact patients' quality of life. We highlight the relevance of adopting non-pharmacological measures to ensure more effective treatment. It is concluded that knowledge of the main adverse effects is of paramount importance to optimize treatment adherence and patients' quality of life, in addition to the inclusion of non-pharmacological measures, such as physical exercise and psychotherapy.