Programme no. 464-P
Fibromyalgia patients in Finnish primary health care: clinical picture, management and quality of life
1Nokia Health Center,Nokia,Finland
* = Presenting author
Objectives: To describe the clinical picture of fibromyalgia patients in Finnish primary health care, their management and the course of the disease.
Background: Persistent and widespread pain, fatigue, stiffness, depression and sleep disruption are the main symptoms of fibromyalgia. Its exact etiology is still unclear. Prevalence of fibromyalgia is 2-4% in adult population and 80-90% of patients are female. 60% of patients are between 30 and 50 years old when the diagnosis is made. It is estimated that in primary care visits the occurrence of fibromyalgia is around 2.1-5.7%. In UK 68%, of diagnoses are made in primary health care, however almost a third of primary care doctors do not ever set a fibromyalgia diagnosis. In UK 46% of primary care physicians reported personally treating 63% of their patients. Most patients with juvenile-onset fibromyalgia continue to experience symptoms in early adulthood and symptoms normally last at least 15 years. Exercise helps to control fibromyalgia symptoms but patients don’t generally like physical interventions. Medications have limited impact on fibromyalgia symptoms. Most fibromyalgia studies have been conducted in rheumatology clinics and there is no previous published research made in Finnish primary health care.
Results: Preliminary results will be presented at the congress.
Material/Methods: Patients with fibromyalgia diagnosis (ICD-10 M79.7 or M79.0 and mention of fibromyalgia in medical record) are identified from the electronic medical record of Nokia Health Center. Four different questionnaires measuring pain, physical function, symptoms, depression and quality of life will be sent to the patients willing to attend the study. After completing these questionnaires doctor’s appointment will be scheduled. Clinical examination will be performed and American College of Rheumatology 2010 Fibromyalgia Diagnostic Criteria questionnaire will be filled. Patients will be asked whether fibromyalgia-diagnosis has been originally made in primary or secondary health care. Patient’s age, sex and other diseases and medications will be registered. Patient will also be asked if they use any herbal products or alternative medicine for fibromyalgia. Other treatment methods (for example exercise) are also asked and patients will be asked if they have attended to multidisciplinary rehabilitation and do they have a personal care plan made by a doctor.
Conclusion: Fibromyalgia is quite common in general practitioner’s appointment. Still there is only limited information how it is presented in primary health care. Studying fibromyalgia patients from primary health care’s perspective might lead to an intervention method applicable in primary health care.
Points for discussion: The role of primary health care and medications in fibromyalgia patient's treament.