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A prospective, longitudinal, multicenter study of service utilization & costs in fibromyalgia (FM)

  [ 48 votes ]   [ Discuss This Article ]
By Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, Russell IJ, Yunus MB • • September 15, 1997

OBJECTIVE: To study, for the first time, service utilization
and costs in fibromyalgia, a prevalent syndrome associated
with high levels of pain, functional disability, and emotional

METHODS: Five hundred thirty-eight fibromyalgia
patients from 6 rheumatology centers were enrolled in a 7-year
prospective study of fibromyalgia outcome. Patients were
assessed every 6 months with validated, mailed questionnaires
which included questions regarding fibromyalgia symptoms and
severity, utilization of services, and work disability.

RESULTS: Fibromyalgia patients averaged almost 10 outpatient
medical visits per year, and when nontraditional treatments
were considered, this number increased to approximately 1
visit per month. Patients were hospitalized at a rate of 1
hospitalization every 3 years. In each 6-month study period,
patients used a mean of 2.7 fibromyalgia-related drugs. Costs
increased over the course of the study. The mean yearly
per-patient cost in 1996 dollars was $2,274. However, results
were skewed by high utilizers, and many patients used few
services and had limited costs. Total costs and utilization
were independently associated with the number of self-reported
comorbid or associated conditions, functional disability, and
global disease severity. Compared with patients with other
rheumatic disorders, those with fibromyalgia were more likely
to have lifetime surgical interventions, including back or
neck surgery, appendectomy, carpal tunnel surgery, gynecologic
surgery, abdominal surgery, and tonsillectomy, and were more
likely than other rheumatic disease patients to report
comorbid or associated conditions. Almost 50% of
hospitalizations occurring during the study were related to
fibromyalgia-associated symptoms.

CONCLUSION: The average
yearly cost for service utilization among fibromyalgia
patients is $2,274. Fibromyalgia patients have high lifetime
and current rates of utilization of all types of medical
services. They report more symptoms and comorbid or associated
conditions than patients with other rheumatic conditions, and
symptom reporting is linked to service utilization and, to a
lesser extent, functional disability and global disease

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