# Fibromyalgia: the Italian survey by the ministry of health

## TL;DR

This paper presents findings from an Italian survey on fibromyalgia care, highlighting regional disparities and the need for a national strategy to improve standardized, multidisciplinary care.

## Contribution

The study provides a comprehensive assessment of fibromyalgia care in Italy and proposes a national strategy to address organizational and clinical gaps.

## Key findings

- 131 fibromyalgia centers were mapped, with only 16% part of regional networks and 21% not using formal care protocols.
- Multidisciplinary teams were dominated by rheumatologists, and critical issues included lack of standardized pathways and limited integration.
- A cloud-based repository and web portal were developed to support information sharing and improve care coordination.

## Abstract

Fibromyalgia (FM) is a chronic condition with complex etiology, characterized by widespread pain and associated symptoms that significantly impact quality of life. In Italy, organizational heterogeneity and the absence of standardized care pathways hinder uniform management. The RF-2019-12369647 project was launched to develop a national strategy for integrated and multidisciplinary care.

A nationwide mapping of clinical centers dedicated to FM was conducted through online reconnaissance and validation by Regional Health Departments. A structured survey was administered to 131 identified centers to collect data on organizational models, clinical workload, and care practices. In addition, a systematic literature review of diagnostic and therapeutic guidelines was performed, and a digital repository was developed to support information sharing.

A total of 131 centers were mapped, and 56 completed the survey (42.7% response rate). Centers managed an average of 485 patients annually, supported by multidisciplinary teams dominated by rheumatologists (91%). Despite territorial coverage, only 16% of centers were part of regional networks, and 21% reported not using any formal care protocol. Critical issues included lack of standardized pathways, insufficient training, and limited multidisciplinary integration. A cloud-based repository and web portal were developed to facilitate knowledge dissemination.

The findings highlight wide regional disparities, fragmented care models, and insufficient adoption of guidelines for FM management in Italy. These results support the urgent need for a coordinated national strategy to ensure equitable, standardized, and multidisciplinary care pathways for patients with fibromyalgia.