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      Burden of Illness Due to Fibromyalgia in a Neurology Clinic

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          Abstract

          Background  Fibromyalgia (FM) is a common disorder in general population and it causes an increased patient load in hospitals and specialty clinics. FM attendance will be high in clinics dealing with neuropathic pain and other pain syndromes. Though prevalence of FM has been studied in community and pain clinics in other countries, it has not so far been studied in India. So, a study is relevant and hence it was planned in neurology clinic of a teaching government hospital. At present, they are treated mainly by nonsteroidal anti-inflammatory drugs (NSAIDs) which are public health hazard.

          Methods  Using 2016 revision of 2010/2011 American College of Rheumatology criteria of FM, patients were screened in neurology OPD. Proportion and clinical profile were noted. Study was continued for 6 months till the sample size was met.

          Results  A total of 2,300 patients were screened. Two hundred and ninety-eight FM patients were identified among them. Proportion was 12.96%. Delayed diagnosis of more than a year occurred in 55%. Only 29.2% were treated, but none was offered cognitive behavioral therapy (CBT) before. NSAIDs for pain were given for 51.01%.

          Conclusion  Proportion of FM detected is considerable. Affection of homemakers and manual laborers, delayed diagnosis, coexisting comorbid illness, and treatment of pain with NSAIDs are causes of concern. Clinicians should be sensitized to clinical profile and criteria of FM. Patients should be diagnosed and treated by CBT at the earliest and NSAIDs should be avoided as far as possible.

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          Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project.

          Daniel Clauw, D Barton, Jennifer St Sauver … (2013)
          To estimate and compare the prevalence of fibromyalgia by 2 different methods in Olmsted County, Minnesota. The first method was a retrospective review of medical records of potential cases of fibromyalgia in Olmsted County using the Rochester Epidemiology Project (from January 1, 2005, to December 31, 2009) to estimate the prevalence of diagnosed fibromyalgia in clinical practice. The second method was a random survey of adults in Olmsted County using the fibromyalgia research survey criteria to estimate the percentage of responders who met the fibromyalgia research survey criteria. Of the 3,410 potential patients identified by the first method, 1,115 had a fibromyalgia diagnosis documented in the medical record by a health care provider. The age- and sex-adjusted prevalence of diagnosed fibromyalgia by this method was 1.1%. By the second method, of the 2,994 people who received the survey by mail, 830 (27.6%) responded and 44 (5.3%) met the fibromyalgia research survey criteria. The age- and sex-adjusted prevalence of fibromyalgia in the general population of Olmsted County by this method was estimated at 6.4%. To the best of our knowledge, this is the first report of the rate at which fibromyalgia is being diagnosed in a community. This is also the first report of prevalence as assessed by the fibromyalgia research survey criteria. Our results suggest that patients, particularly men, who meet the fibromyalgia research survey criteria are unlikely to have been given a diagnosis of fibromyalgia. Copyright © 2013 by the American College of Rheumatology.
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            A patient survey of the impact of fibromyalgia and the journey to diagnosis

            Ernest Choy, Serge Perrot, Ana Teresa León … (2010)
            Background Fibromyalgia is a painful, debilitating illness with a prevalence of 0.5-5.0% that affects women more than men. It has been shown that the diagnosis of fibromyalgia is associated with improved patient satisfaction and reduced healthcare utilization. This survey examined the patient journey to having their condition diagnosed and studied the impact of the condition on their life. Methods A questionnaire survey of 800 patients with fibromyalgia and 1622 physicians in 6 European countries, Mexico and South Korea. Patients were recruited via their physician. Results Over half the patients (61%) were aged 36-59 years, 84% were women, and the mean time since experiencing fibromyalgia symptoms was 6.5 years. Patients had experienced multiple fibromyalgia symptoms (mean of 7.3 out of 14), with pain, fatigue, sleeping problems and concentration difficulties being the most commonly reported. Most patients rated their chronic widespread pain as moderate or severe and fibromyalgia symptoms were on average "fairly" to "very" disruptive, and had a "moderate" to "strong" impact on patients' lives. 22% were unable to work and 25% were not able to work all the time because of their fibromyalgia. Patients waited on average almost a year after experiencing symptoms before presenting to a physician, and it took an average of 2.3 years and presenting to 3.7 different physicians before receiving a diagnosis of fibromyalgia. Patients rated receiving a diagnosis as somewhat difficult on average and had difficulties communicating their symptoms to the physician. Over one third (35%) felt their chronic widespread pain was not well managed by their current treatment. Conclusions This survey provides further evidence that fibromyalgia is characterized by multiple symptoms and has a notable impact on quality of life and function. The diagnosis of fibromyalgia is delayed. Patients wait a significant period of time before presenting to a physician, adding to the prolonged time to diagnosis. Patients typically present with a multitude of symptoms, all resulting in a delay in diagnosis and eventual management. Helping clinicians to diagnose and manage patients with fibromyalgia should benefit both patients and funders of healthcare.
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              Prevalence of fibromyalgia: literature review update

              Susan Yuan, Luciana Akemi Matsutani, Ana Assumpção Berssaneti … (2017)
              ABSTRACT The present study aimed to update the literature review on the prevalence of fibromyalgia published in 2006. A bibliographical survey was carried out from 2005 to 2014 in the MEDLINE, Web of Science, Embase, LILACS and SciELO databases and 3274 records were identified. Five researchers selected the studies, following the inclusion criteria: studies that obtained the prevalence of fibromyalgia. Fibromyalgia studies in associated diseases were excluded. When screening by title and abstract, 2073 irrelevant articles were excluded. The full texts of 210 articles were evaluated for eligibility and this review included 39 studies, described in 41 articles. The selected studies were grouped into four categories: (A) prevalence of fibromyalgia in the general population; (B) prevalence of fibromyalgia in women; (C) prevalence of fibromyalgia in rural and urban areas; (D) prevalence of fibromyalgia in special populations. The literature shows values of fibromyalgia prevalence in the general population between 0.2 and 6.6%, in women between 2.4 and 6.8%, in urban areas between 0.7 and 11.4%, in rural areas between 0.1 and 5.2%, and in special populations values between 0.6 and 15%. This literature review update shows a significant increase in fibromyalgia prevalence studies in the world. The new 2010 American College of Rheumatology criteria have not been widely used yet and the COPCORD (Community-oriented program for control of Rheumatic Diseases) methodology has increased the quality of studies on the prevalence of rheumatic diseases in general.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Neurosci Rural Pract
                Journal ID (iso-abbrev): J Neurosci Rural Pract
                Journal ID (doi): 10.1055/s-00043281
                Title: Journal of Neurosciences in Rural Practice
                Publisher: Thieme Medical and Scientific Publishers Private Ltd. (A-12, Second Floor, Sector -2, NOIDA -201301, India )
                ISSN (Print): 0976-3147
                ISSN (Electronic): 0976-3155
                Publication date (Print): July 2020
                Publication date (Electronic): 12 June 2020
                Volume: 11
                Issue: 3
                Pages: 411-415
                Affiliations
                [1 ]Department of Neurology, Government Medical College Hospital, Kottayam, Kerala, India
                [2 ]Department of Medical Education, Government Medical College Hospital, Kottayam, Kerala, India
                [3 ]Department of Community Medicine, Government Medical College Hospital, Kottayam, Kerala, India
                Author notes
                Address for correspondence Beena Vasanthy Vijayan, MD, DM Department of Neurology, Government Medical College Hospital Narayaneeyam, Gandhinagar P.O., Kottayam 686008, KeralaIndia beenavdr@ 123456gmail.com
                Article
                Publisher ID: JNRP1900339
                DOI: 10.1055/s-0040-1712586
                PMC ID: 7394628
                PubMed ID: 32753805
                SO-VID: 15665234-ac9f-4823-8d2d-f6d1c7a77182
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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                Subject: Original Article

                ScienceOpen disciplines: Neurosciences
                Keywords: fibromyalgia,burden,clinic,community
                Data availability:
                ScienceOpen disciplines: Neurosciences
                Keywords: fibromyalgia, burden, clinic, community

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