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Health status & disease severity in fibromyalgia (FM): results of a six-center longitudinal study

  [ 97 votes ]   [ Discuss This Article ]
By Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, Russell IJ, Yunus MB • • September 10, 1997

OBJECTIVE: To determine the intermediate and long-term
outcomes of fibromyalgia in patients seen in rheumatology
centers in which there is special interest in the syndrome.

METHODS: We conducted a longitudinal outcome study by mailed
comprehensive Health Assessment Questionnaire administered
every 6 months to 538 patients, from 6 rheumatology centers,
whose median duration of disease at first assessment was 7.8
years. The final assessment took place after 7 years. In
addition, there was study followup on 85 patients who had
attended the Wichita center for > 10 years.

RESULTS: Although
functional disability worsened slightly and health
satisfaction improved slightly, measures of pain, global
severity, fatigue, sleep disturbance, anxiety, depression, and
health status were markedly abnormal at study initiation and
were essentially unchanged over the study period. Correlations
between first and last assessment values were as high as r =
0.82. For some variables, abnormalities were 3 times greater
at one center compared with another.

CONCLUSION: Patients with
established fibromyalgia, seen in rheumatology centers in
which there a special interest in the disease and followed up
for as long as 7 years, have markedly abnormal scores for
pain, functional disability, fatigue, sleep disturbance, and
psychological status, and these values do not change
substantially over time. Half the patients are dissatisfied
with their health, and 59% rate their health as fair or poor.

There are marked differences in disease severity among the
various centers, but < 14% of the variance in outcomes can be
explained by demographic or center factors. Values at the
first assessment are predictive of final values.

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