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The real world of fibromyalgia: Case-by-case search for help among scores of drugs, therapies

  [ 7 votes ]   [ 1 Comment ] • October 21, 2012

Burden of Illness and Treatment Patterns for Patients with Fibromyalgia
- Source: Pain Medicine, Oct 2012

By Rebecca L Robinson, et al.

Objective: This study was designed to describe burden of illness and treatment patterns, and to examine the patient, physician, and care factors associated with the treatment choices of individuals receiving new prescriptions for fibromyalgia (FM).

Design: This is a baseline assessment of the Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments (REFLECTIONS), a prospective observational study.

Baseline data (including a physician survey, a patient visit form, and computer-assisted telephone interviews) were collected from July 2008 through May 2010 in 58 care settings in the United States, including Puerto Rico.


Patients (N = 1,700) were mostly female (94.6%) and white (82.9%).

Mean age was 50.4 years and mean duration of illness was 5.6 years.

Mean Fibromyalgia Impact Questionnaire total score was 54.4 (range 0–80), and Brief Pain Inventory average pain severity level was 5.5 (range 0–10).

Patients reported high annual health care use and numerous work limitations related to FM.

Patients were taking 182 unique types of medications prescribed for FM, including:

• Duloxetine [Cymbalta] (26.8%),

• Nonsteroidal anti-inflammatory drugs (26.6%),

• Pregabalin [Lyrica] (24.5%),

• Opioids (24.2%),

• Tramadol (15.3%),

• Benzodiazepines (15.2%),

• Cyclobenzaprine (12.9%),

• Milnacipran [Savella] (8.9%), and others.

Most patients took more than one medication concurrently (77.8%).

Type of current medications used was most strongly associated with medication history and physician specialty.


Burden of illness was high for patients with FM, and treatment patterns were highly variable.

Importantly, the treatments with the most evidence to support their use were not always the most frequently chosen.

Source: Pain Medicine, Oct 2012;13(10), pp 1366-1376. DOI: 10.1111/j.1526-4637.2012.01475.x by Robinson RL, Kroenke K, Mease P, Williams D, Chen Y, D’Souza D, Wohlreich M, McCarberg B. Eli Lilly, Indianapolis, Indiana; Indiana University, Indianapolis; Regenstrief Institute, Indianapolis; VA HSR& Center, Indianapolis, Seattle Rheumatology Assoc. Swedish Medical Center, Seattle, Washington; Chronic Pain & Fatigue Research Center, University of Michigan, Ann Arbor; PharmaNet/i3 Indianapolis and Ann Arbor; Kaiser Permanente, Escondido California, USA. [Email:]

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Article Comments Post a Comment

Very enlightening
Posted by: IanH
Oct 21, 2012
Thank You.
Reply Reply
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