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Gender-and age-specific fibromyalgia-related discharges, 1999-2007. 

Gender-and age-specific fibromyalgia-related discharges, 1999-2007. 

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To evaluate hospitalisation data for patients with a primary or secondary fibromyalgia (FM) diagnosis. We estimated the number of men and women with an FM diagnostic code and compared them across a number of demographic and hospitalisation characteristics; examined age-specific, population-based FM hospitalisation rates; and determined the most com...

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... The polysymptomatic distress scale (PDS), score range: (0-31) was also evaluated. Based on the PDS, which is the summation of WPI and SSS, the disease severity could be classified as none (0-3), mild (4-7), moderate (8)(9)(10)(11), severe (12)(13)(14)(15)(16)(17)(18)(19), and very severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). 12 The Revised Fibromyalgia Impact Questionnaire (FIQR) 13 includes other symptoms such as cognitive issues, pain, balance, and environmental sensitivity. ...
... 22,23 There was a significant female predominance where the female to male ratio was 3.9:1, which is in accordance with previously published studies. [24][25][26] 27 Two studies from the United States, however, show that patients frequently wait 5 years before ...
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Background The impact of delayed diagnosis (DD) on fibromyalgia (FM) patients’ symptomatology and disease outcome has not yet been systematically studied. Objective To analyze the predictors of DD and the influence of DD on FM aggravation and disease evaluation measures. Methods 370 FM patients were interviewed prospectively for this study. The following information was obtained: DD, widespread pain index (WPI), symptom severity scale (SSS), polysymptomatic distress scale (PDS) scale (SSS + WPI), and tender points. We identified three groups of patients: early diagnosis (ED: 2 years; 83 patients), late diagnosis (LD: > 2–7 years; 198 patients), and very late diagnosis (VLD: > 7 years; 89 patients). Results The patients’ average age was 33.9 (9.8) years, and 79% were female. The SSS, PDS, and tender point means were 7.8 (1.6), 16.46 (4.1), and 14.31 (2.3), respectively. The correlation between DD and SSS (r = 0.14), the PDS scale (r = 0.37), and FM tender points (r = 0.16) was significant, but not with WPI (r = 0.06). When the three groups were examined, the SSS mean was 7.54 (1.6), 7.73 (1.4), and 8.25 (1.7), respectively (P 0.008), while the PDS mean was 15 (3.8), 15.95 (3.8), and 18.96 (4.4), respectively (P 0.008). (P 0.001). Conclusion Early FM diagnosis is associated with lower SSS, total severity scale, and FM tender points, indicating a less severe condition.
... 1,2,4 Patients with fibromyalgia have one or more comorbidities such as musculoskeletal conditions, metabolic disorders, heart diseases, and mental disorders. 5,6 The global mean prevalence of fibromyalgia is approximately 2.7%, and females are affected more than males. 6 General treatment principles of fibromyalgia require a wide-ranging assessment of pain, function, and psychosocial aspects. ...
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Objective: To examine the effectiveness of electrophysical agents in fibromyalgia. Data sources: CINAHL, Cochrane Library, Embase, Medline, PEDro, and Web of Science were searched from their inceptions to March 27, 2023. Methods: This study was registered in PROSPERO (CRD42022354326). Methodological quality of included trials was assessed using PEDro scale, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. The primary outcomes were pain, functional status, and mood. Results: Fifty-four studies involving 3045 patients with fibromyalgia were eligible for qualitative synthesis and 47 (pain), 31 (functional status), and 26 (mood) for network meta-analysis. The network consistency model revealed that, when compared with true control, transcutaneous electrical nerve stimulation and microcurrent improved pain symptoms (P=0.006 and P=0.037, respectively); repetitive transcranial magnetic stimulation improved patient functional status (P=0.018); and microcurrent (P=0.001), repetitive transcranial magnetic stimulation (P =0.022), and no treatment (P=0.038) significantly improved mood after intervention. Surface under the cumulative ranking indicated that microcurrent was most likely to be the best for managing pain and mood (surface under the cumulative ranking: 70% and 100%, respectively); low-level laser therapy for pain and mood (80% and 70%, respectively); and repetitive transcranial magnetic stimulation for improving functional status and mood (80% and 70%, respectively). Conclusion: This review found low to moderate quality evidence that microcurrent, laser therapy, and repetitive transcranial magnetic stimulation are the most effective electrophysical agents for improving at least one outcome in fibromyalgia.
... Fibromyalgia is a chronic condition characterized by fatigue, sleep hygiene issues, and musculoskeletal pain affecting approximately 2.7% of the population worldwide and an estimated four million adults in the United States alone (Clauw, 2009;Giacomelli et al., 2013;Queiroz, 2013; Centers for Disease Control [CDC], 2020). Fibromyalgia disproportionately impacts women, individuals with a history of trauma and post-traumatic stress disorder, and those who are obese and overweight (Häuser et al., 2013;Haviland et al., 2011;Hawkins, 2013;Mork et al., 2010). Of concern, individuals with fibromyalgia are at risk for poorer mental (e.g., depression, anxiety, suicidal behavior) and physical health outcomes (e.g., pain, fatigue) compared to not only the general population but also other individuals with chronic pain conditions (Galvez-Sánchez et al., 2019;Picavet & Hoeymans, 2004), warranting investigation of protective factors that may bolster subjective health among individuals with fibromyalgia. ...
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... As a next step, increased muscle tension can be a local trauma, physiological dysfunction, and lead to a defensive response to psychological burden 34 . A central mechanism in the development of muscle pain due to prolonged overactivity is primarily concerned with the muscles that tense when experiencing psychological discomfort, anxiety, or stress 35 . Specifically, the masseter muscle, temporal muscle, sternocleidomastoid muscle, and trapezius muscle are typical examples mentioned when discussing the central mechanism. ...
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... Na Espanha, pacientes com FM ocupam de 10%-20% das consultas reumatológicas e de 5%-8% das consultas com clínicos gerais (Oliveira Júnior & Ramos, 2019). Nos Estados Unidos (EUA), estima-se que 200.000 hospitalizações anualmente estejam associadas à FM (Haviland et al., 2011). Em grande parte, a utilização exacerbada de recursos em saúde por pacientes com FM é consequência da longa e complexa jornada encontrada por profissionais da saúde no diagnóstico e na prescrição de um tratamento, dada a apresentação clínica variada da doença, o número elevado de comorbidades e, também, a falta de um algoritmo de tratamento universal e validado, tornando o tratamento frequentemente inadequado ou inefetivo (Haviland et al., 2011;Liu et al., 2016). ...
... Nos Estados Unidos (EUA), estima-se que 200.000 hospitalizações anualmente estejam associadas à FM (Haviland et al., 2011). Em grande parte, a utilização exacerbada de recursos em saúde por pacientes com FM é consequência da longa e complexa jornada encontrada por profissionais da saúde no diagnóstico e na prescrição de um tratamento, dada a apresentação clínica variada da doença, o número elevado de comorbidades e, também, a falta de um algoritmo de tratamento universal e validado, tornando o tratamento frequentemente inadequado ou inefetivo (Haviland et al., 2011;Liu et al., 2016). Além disso, a grande utilização de consultas médicas, o número elevado de medicamentos e de abordagens não farmacológicas, bem como o impacto negativo na produtividade do trabalho, aumentam o consumo de cuidados em saúde, o que demostra que os gastos com custos diretos e indiretos são substanciais nesses pacientes, impactando diretamente a alocação de recursos nos sistemas de saúde (Liu et al., 2016). ...
... As amostras das populações nos artigos selecionados eram geograficamente diversas, porém suas características demográficas e clínicas eram muito similares às de outras amostras de pacientes com FM na literatura publicada (Haviland et al., 2011;van Eijk-Hustings et al., 2016). Mesmo a FM não sendo considerada uma condição de maior prevalência global, é foco de investigações por se apresentar clinicamente heterogênea e dispendiosa aos sistemas de saúde (Souza & Perissinotti, 2018). ...
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Objetivo: Identificar os custos médicos diretos e indiretos de pacientes com fibromialgia (FM), bem como elucidar os recursos em saúde utilizados. Métodos: Foi realizada uma revisão de escopo nas bases de dados Medline/PubMed, SciELO e Lilacs, tendo como critérios de inclusão publicações que versavam sobre os custos da FM, publicadas a partir de 2009, disponíveis eletronicamente na íntegra, nos idiomas português, inglês ou espanhol. As buscas foram realizadas entre fevereiro de 2019 e abril de 2021. Resultados: Foram identificados 124 artigos, sendo selecionados 9. Os estudos selecionados foram desenvolvidos na Europa (n=5), América do Norte (n=3) e Ásia (n=1). O número de participantes nos estudos variou de 57 a 2.098, com maior predomínio de pacientes do sexo feminino e idade média variando de 42,6 a 55,2 anos. A média de comorbidades foi de 2,4 a 4,9 por paciente, com um tempo de diagnóstico variando de 4,3 a 6,9 anos. A média do número de consultas médicas variou de 4,68 a 23,3 por paciente/ano, sendo os custos diretos anuais, convertidos para o ano de 2021, de U925,62aU 925,62 a U 8.116,59, representando 10,5% a 37,6% dos valores dos custos totais. A média anual de custos indiretos variou de U7.274,98aU 7.274,98 a U 32.294,87, representando 62,4% a 89,5% dos custos totais. Conclusão: Os custos diretos identificados refletiram um panorama do modelo assistencial adotado pelos países que compuseram esta pesquisa e identificamos maior sobrecarga de custos indiretos em relação aos custos totais por paciente, demonstrando maior impacto na comunidade.
... The majority of the participants were women and only 3,7% of the sample were men. The prevalence of diagnosed fibromyalgia is known to have a female dominance (Heidari et al., 2017;Haviland et al., 2011) so the low percentage of men in the sample is not surprising. However, there is research indicating that the assessment of fibromyalgia is biased so that men are underdiagnosed (Wolfe et al., 2018). ...
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Background Research show that fibromyalgia has low credibility in healthcare, leading to poor treatment, lack of knowledge and disinterest. Therefore, people with fibromyalgia feel frustration, fear, anxiety and disappointment. Objective: The aim of this study was to explore the experiences of people with fibromyalgia in their encounters with healthcare personnel in Sweden. Method: A cross-sectional design, where 409 people with fibromyalgia answered an anonymous online patient-reported experience measure, developed specific for the study, with six closed questions and one open-ended question. Descriptive statistics were analysed by response frequencies. Correlation analysis were performed between demographic and clinical variables with the answers from the closed questions. Free-text answers were analysed with content analysis. Results: A third experienced the treatment as bad (34%) and that they were not being taken seriously (30.5%). Almost half (47%) always or mostly felt fear of seeking healthcare related to fibromyalgia and that the health care personnel did not understand their diagnosis (46%). The majority (54%) experienced that the health care personnel did not understand how fibromyalgia affected them or how they could help them. The findings were confirmed in the free-text answers that were categorized into: Scepticism and disregard, Ignorance and disinterest and Professionalism and empathy. There were positive significant correlations between age and five of the questions (ρ = .105–.181, p < .05–p < .01), indicating that lower age is correlated with a worse experience. Furthermore, the duration of fibromyalgia showed a significant correlation with feeling afraid of seeking healthcare because of fibromyalgia (ρ = .144, p < .01), the shorter duration, the greater was the fear of seeking healthcare. Conclusion: As a third of patients with fibromyalgia had bad experiences with healthcare, especially younger patients, knowledge about fibromyalgia needs to be increased and the patients should be taken seriously and treated respectfully, as well as given adequate support.
... As fibromyalgia is primarily treated in outpatient settings, health economics research has focussed on the cost of outpatient care [10]. However, a small number of studies conducted predominantly over a decade ago suggested that healthcare use is not restricted to primary care and that a large portion of direct medical costs arise from hospitalization in this patient group [10,12,13]. This aspect of the economic burden may reflect the inadequacy of current outpatient-based management or a failure to follow treatment recommendations. ...
... The latter is used to code for myalgia, including for example myofascial pain, but not myositis. It was included to try and investigate patients who may have been admitted due to symptoms consistent with a diagnosis of fibromyalgia, even if it was not reported in the discharge summary, in keeping with previous approaches to capture cases of fibromyalgia [12]. ...
... This is of limited value given the marked differences between the two healthcare systems. The US also demonstrated a clear female preponderance and a similar peak age range of between 45 and 64 years of age for admissions to hospital for fibromyalgia [10,12,13,19]. A gradual increase in fibromyalgia-related admissions was also demonstrated between 1999 and 2007 in the US [12]. ...
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Objectives: Fibromyalgia is a complex, debilitating, multifactorial condition that can be difficult to manage. Recommended treatments are usually delivered in outpatient settings; evidence suggests that significant inpatient care occurs. We describe the scale and cost of inpatient care with a primary diagnostic code of fibromyalgia within the English National Health Service. Methods: We conducted a cohort-level observational study of all patients admitted to hospital due to a diagnosis of fibromyalgia, between 1 April 2014 and 31 March 2018 inclusive, in the National Health Service in England. We used data from Hospital Episode Statistics Admitted Patient Care to study: the age and sex of patients admitted, number and costs of admissions, length of stay, procedures undertaken, class and type of admission, and distribution of admissions across clinical commissioning groups. Results: A total of 24 295 inpatient admissions, costing £20 220 576, occurred during the 4-year study period. Most patients were women (89%) with peak age of admission of between 45 and 55 years. Most admissions were elective (92%). A number of invasive therapeutic procedures took place, including a continuous i.v. infusion (35%). There was marked geographical variation in the prevalence and cost of inpatient fibromyalgia care delivered across the country, even after accounting for clinical commissioning group size. Conclusions: Many patients are admitted for treatment of their fibromyalgia and given invasive procedures for which there is weak evidence, with significant variation in practice and cost across the country. This highlights the need to identify areas of resource use that can be rationalized and diverted to provide more effective, evidence-based treatment.
... Fibromyalgia is a chronic pain condition, affecting an estimated 2.7% of the population worldwide (Queiroz, 2013). There are sex differences in prevalence rates; fibromyalgia is seven times more common in women (Hawkins, 2013), affecting 3.4% of women versus 0.5% of men in the general population (Haviland, Banta, & Przekop, 2011). Fibromyalgia is characterized by widespread pain and fatigue, feelings of stiffness, tingling, or numbness, and headaches, as well as sleep disturbances and neurocognitive impairments (Clauw, 2009;Giacomelli et al., 2013). ...
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Individuals with fibromyalgia are at greater risk for depressive symptoms than the general population, and this may be partially attributable to physical symptoms that impair day‐to‐day functioning. However, individual‐level protective characteristics may buffer risk for psychopathology. For instance, the ability to perceive a “silver lining” in one’s illness may be related to better mental and physical health. We examined perceived silver lining as a potential moderator of the relation between fibromyalgia impact and depressive symptoms. Our sample of persons with fibromyalgia (N = 401) completed self‐report measures including the Fibromyalgia Impact Questionnaire‐Revised, Depression Anxiety Stress Scales, and the Silver Lining Questionnaire. Moderation analyses covaried age, sex, and ethnicity. Supporting hypotheses, increasing impact of disease was related to greater depressive symptoms, and perceptions of a silver lining attenuated that association. Despite the linkage between impairment and depressive symptoms, identifying positive aspects or outcomes of illness may reduce risk for psychopathology. Therapeutically promoting perception of a silver lining, perhaps via signature strengths exercises or a blessings journal, and encouraging cognitive reframing of the illness experience, perhaps via Motivational Interviewing or Cognitive Behavioral Therapy, may reduce depressive symptoms in persons with fibromyalgia.
... We wished to identify comorbidities that may influence physical therapy outcomes, neck pain prognosis or healthcare seeking behaviors from recorded ICD-9 codes in the claims data within the 1-year period following the index date. We recorded the following provider-entered comorbidities: low back pain [21], fibromyalgia [28], chronic or generalized pain [29], substance abuse, depression and anxiety [30], tobacco use and obesity (see Additional file 1 for ICD-9 codes used for co-morbidity identification). ...
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Background Patients seek care from physical therapists for neck pain but it is unclear what the association of the timing of physical therapy (PT) consultation is on 1-year healthcare utilization and costs. The purpose of this study was to compare the 1-year healthcare utilization and costs between three PT timing groups: patients who consulted a physical therapist (PT) for neck pain within 14 days (early PT consultation), between 15 and 90 days (delayed PT consultation) or between 91 and 364 days (late PT consultation). Methods A retrospective cohort of 308 patients (69.2% female, ages 48.7[±14.5] years) were categorized into PT timing groups. Descriptive statistics were calculated for each group. In adjusted regression models, 1-year healthcare utilization of injections, imaging, opioids and costs were compared between groups. Results Compared to early PT consultation, the odds of receiving an opioid prescription (aOR = 2.79, 95%CI: 1.35–5.79), spinal injection (aOR = 4.36, 95%CI:2.26–8.45), undergoing an MRI (aOR = 4.68, 95%CI:2.25–9.74), X-ray (aOR = 2.97, 95%CI:1.61–5.47) or CT scan (aOR = 3.36, 95%CI: 1.14–9.97) were increased in patients in the late PT consultation group. Similar increases in risk were found in the delayed group (except CT and Opioids). Compared to the early PT consultation group, mean costs were 2172(2172 (557, 3786)higherinthelatePTcontactgroupand3786) higher in the late PT contact group and 1063 (95%CI: 138 138 - 1988) higher in the delayed PT consultation group. Discussion There was an association with the timing of physical therapy consultation on healthcare utilization and costs, where later consultation was associated with increases costs and healthcare utilization. This study examined the association of timing of physical therapy consultation on costs and healthcare utilization, but not the association of increased access to physical therapy consultation. Therefore, the findings warrant further investigation to explore the effects of increased access to physical therapy consultation on healthcare utilization and costs in a prospective study. Electronic supplementary material The online version of this article (10.1186/s12913-018-3699-0) contains supplementary material, which is available to authorized users.
... As reserpine-treated rats show similar biochemical and phenotypic features to fibromyalgia in humans, I 2 R agonists may represent a novel treatment for fibromyalgia pain and potentially comorbid depression. It should be noted that because only male rats were used in this study and the prevalence of fibromyalgia is higher in women than in men (Haviland et al., 2011), it is possible that the results can only be applied to a specific population. ...
Article
Pharmacotherapies for fibromyalgia treatment are lacking. This study examined the antinociceptive and antidepressant-like effects of imidazoline I2 receptor (I2R) agonists in a reserpine-induced model of fibromyalgia in rats. Rats were treated for 3 days with vehicle or reserpine. The von Frey filament test was used to assess the antinociceptive effects of I2 receptor agonists, and the forced swim test was used to assess the antidepressant-like effects of these drugs. 2-BFI (3.2-10 mg/kg, intraperitoneally), phenyzoline (17.8-56 mg/kg, intraperitoneally), and CR4056 (3.2-10 mg/kg, intraperitoneally) all dose-dependently produced significant antinociceptive effects, which were attenuated by the I2R antagonist idazoxan. Only CR4056 significantly reduced the immobility time in the forced swim test in both vehicle-treated and reserpine-treated rats. These data suggest that I2R agonists may be useful to treat fibromyalgia-related pain and comorbid depression.