Presentation: What Level of Symptom Relief Do Fibromyalgia Patients Expect During a Rheumatology Office Visit? (2007)

1538 What Level of Symptom Relief Do Fibromyalgia Patients Expect During a Rheumatology Office Visit?

Fibromyalgia (FM) often results in significant impairments in physical functioning and emotional distress, as well as decreased quality of life. FM patients are often frustrated and dissatisfied with medical treatments resulting in greater numbers of medical visits and health care cost. Patient-centered treatment outcomes (PCO) represent and important approach to determine the success of the treatment and this model promotes greater satisfaction with health care, improves treatment compliance, and increases maintenance of patient-provider relationships. The purposes of this study was to investigate FM patients’ expectations regarding clinically relevant outcomes in pain, fatigue, distress, and interference with daily activities (ADL) during a rheumatology clinic visit.
Methods: PCO questionnaire was used during a clinic visit which assesses 4 domains relevant to chronic pain (pain, fatigue, distress, interference with ADL) on an 11-point numerical rating scale from 0-10. The PCO asks patients to rate the improvement of these 4 domains that they expect during treatment. Results: 294 FM patients (24 males (8%) & 270 females (92%), 80.0% Caucasian; Mean age: 46.91 years. FM patients rated their usual pain during the last week as 7.16 VAS, usual fatigue 7.6 VAS, usual distress 6.12 VAS, usual interference with ADL 7.1 VAS (Figure 1). Reductions of 56% (3.20 VAS) in pain, 61% (2.97 VAS) in fatigue, 60% (2.45 VAS) in distress, and 63% (2.63 VAS) in interference were required for FM patients to consider treatment a success, which is consistent with previous findings and underscores the need for examining success from the patient perspective.
Conclusions: FM patients have great expectations about reductions in pain, fatigue, distress, and interference related to a Rheumatology office visit. Benefits of incorporating patients’ perspective into treatment evaluations will improve communicating with patients about their definitions for treatment success, helping patients prioritize their goals, make informed choices about treatment, and maintain realistic expectations, guiding rheumatologists in clinical decision making, and promoting better relationships between providers and their patients
Figure 1
PCO Ratings of 294 Fibromyalgia Patients

  R. Staud, NIH, 2; E. O'Brien, None; J.G. Craggs, None; D.D. Price, None; M.E. Robinson, None.