Cargando…

Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care

PURPOSE: To evaluate the effect of physician specialty regarding diagnosis and treatment of fibromyalgia (FM) and assess the clinical status of patients initiating new treatment for FM using data from Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments. PATIENTS A...

Descripción completa

Detalles Bibliográficos
Autores principales: Able, Stephen L, Robinson, Rebecca L, Kroenke, Kurt, Mease, Philip, Williams, David A, Chen, Yi, Wohlreich, Madelaine, McCarberg, Bill H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5085275/
https://www.ncbi.nlm.nih.gov/pubmed/27799842
http://dx.doi.org/10.2147/POR.S79441
_version_ 1782463541402402816
author Able, Stephen L
Robinson, Rebecca L
Kroenke, Kurt
Mease, Philip
Williams, David A
Chen, Yi
Wohlreich, Madelaine
McCarberg, Bill H
author_facet Able, Stephen L
Robinson, Rebecca L
Kroenke, Kurt
Mease, Philip
Williams, David A
Chen, Yi
Wohlreich, Madelaine
McCarberg, Bill H
author_sort Able, Stephen L
collection PubMed
description PURPOSE: To evaluate the effect of physician specialty regarding diagnosis and treatment of fibromyalgia (FM) and assess the clinical status of patients initiating new treatment for FM using data from Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments. PATIENTS AND METHODS: Outpatients from 58 sites in the United States were enrolled. Data were collected via in-office surveys and telephone interviews. Pairwise comparisons by specialty were made using chi-square, Fisher’s exact tests, and Student’s t-tests. RESULTS: Physician specialist cohorts included rheumatologists (n=54), primary care physicians (n=25), and a heterogeneous group of physicians practicing pain or physical medicine, psychiatry, neurology, obstetrics and gynecology, osteopathy, or an unspecified specialty (n=12). The rheumatologists expressed higher confidence diagnosing FM (4.5 on a five-point scale) than primary care physicians (4.1) (P=0.037). All cohorts strongly agreed that recognizing FM is their responsibility. They agreed that psychological aspects of FM are important, but disagreed that symptoms are psychosomatic. All physician cohorts agreed with a multidisciplinary approach including nonpharmacological and pharmacological treatments, although physicians were more confident prescribing medications than alternative therapies. Most patients reported moderate to severe pain, multiple comorbidities, and treatment with several medications and nonpharmacologic therapies. CONCLUSION: Physician practice characteristics, physician attitudes, and FM patient profiles were broadly similar across specialties. The small but significant differences reported by physicians and patients across physician cohorts suggest that despite published guidelines, treatment of FM still contains important variance across specialties.
format Online
Article
Text
id pubmed-5085275
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-50852752016-10-31 Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care Able, Stephen L Robinson, Rebecca L Kroenke, Kurt Mease, Philip Williams, David A Chen, Yi Wohlreich, Madelaine McCarberg, Bill H Pragmat Obs Res Original Research PURPOSE: To evaluate the effect of physician specialty regarding diagnosis and treatment of fibromyalgia (FM) and assess the clinical status of patients initiating new treatment for FM using data from Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments. PATIENTS AND METHODS: Outpatients from 58 sites in the United States were enrolled. Data were collected via in-office surveys and telephone interviews. Pairwise comparisons by specialty were made using chi-square, Fisher’s exact tests, and Student’s t-tests. RESULTS: Physician specialist cohorts included rheumatologists (n=54), primary care physicians (n=25), and a heterogeneous group of physicians practicing pain or physical medicine, psychiatry, neurology, obstetrics and gynecology, osteopathy, or an unspecified specialty (n=12). The rheumatologists expressed higher confidence diagnosing FM (4.5 on a five-point scale) than primary care physicians (4.1) (P=0.037). All cohorts strongly agreed that recognizing FM is their responsibility. They agreed that psychological aspects of FM are important, but disagreed that symptoms are psychosomatic. All physician cohorts agreed with a multidisciplinary approach including nonpharmacological and pharmacological treatments, although physicians were more confident prescribing medications than alternative therapies. Most patients reported moderate to severe pain, multiple comorbidities, and treatment with several medications and nonpharmacologic therapies. CONCLUSION: Physician practice characteristics, physician attitudes, and FM patient profiles were broadly similar across specialties. The small but significant differences reported by physicians and patients across physician cohorts suggest that despite published guidelines, treatment of FM still contains important variance across specialties. Dove Medical Press 2016-05-20 /pmc/articles/PMC5085275/ /pubmed/27799842 http://dx.doi.org/10.2147/POR.S79441 Text en © 2016 Able et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Able, Stephen L
Robinson, Rebecca L
Kroenke, Kurt
Mease, Philip
Williams, David A
Chen, Yi
Wohlreich, Madelaine
McCarberg, Bill H
Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care
title Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care
title_full Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care
title_fullStr Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care
title_full_unstemmed Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care
title_short Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care
title_sort variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5085275/
https://www.ncbi.nlm.nih.gov/pubmed/27799842
http://dx.doi.org/10.2147/POR.S79441
work_keys_str_mv AT ablestephenl variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare
AT robinsonrebeccal variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare
AT kroenkekurt variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare
AT measephilip variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare
AT williamsdavida variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare
AT chenyi variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare
AT wohlreichmadelaine variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare
AT mccarbergbillh variationsinthemanagementoffibromyalgiabyphysicianspecialtyrheumatologyversusprimarycare