Evidence-Based Self-Management Strategies for Fibromyalgia: Foundations for Digital Therapeutic Applications (Preprint)

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UNSTRUCTURED Fibromyalgia is a prevalent musculoskeletal pain condition that causes major personal, social, and societal burden. Pharmacological therapies often provide only limited benefit, making multimodal approaches and self-management the cornerstones of care. Such strategies, spanning lifestyle modification, physical activity, psychoeducation, and cognitive-behavioral approaches, target the biopsychosocial complexity of fibromyalgia and promote sustainable coping. In parallel, digital health technologies are transforming how these interventions can be delivered and coordinated in the form of digital therapeutics. This viewpoint draws on a multiphase investigation to appraise the current and future landscape of fibromyalgia self-management in the digital era. Its objective is to present an evidence-based framework and recommendations to guide the development of a mobile health self-management program for patients with fibromyalgia. In phase 1, we conducted a review of international guidelines and randomized controlled trial–based systematic reviews addressing nondigital self-management interventions for fibromyalgia and related nociplastic pain conditions. In phase 2, we analyzed the content and certification status of currently available mobile and virtual health applications for fibromyalgia. In phase 3, we convened a multidisciplinary focus group of rheumatologists, patients, and digital health developers to identify priorities for translating evidence-based self-management content into mobile health formats. Collectively, we suggest that effective digital self-management for fibromyalgia should evolve beyond single-domain interventions toward validated, personalized, and interactive multimodal platforms. Virtual care may increasingly function at the point of care, linking monitoring, education, and behavioral support in one continuum.

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