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

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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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