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Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes
BACKGROUND: One-third of primary care providers (PCPs) refer patients with fibromyalgia or chronic pain (FM/CP) to specialist care, typically rheumatology. Yet, comprehensive data on the quality of rheumatology care for patients with FM/CP are currently lacking. METHODS: Records of patients referred...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996658/ https://www.ncbi.nlm.nih.gov/pubmed/33766832 http://dx.doi.org/10.1136/bmjoq-2020-001061 |
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author | Pang, Hilary YM Farrer, Chandra Wu, Wei Gakhal, Natasha K |
author_facet | Pang, Hilary YM Farrer, Chandra Wu, Wei Gakhal, Natasha K |
author_sort | Pang, Hilary YM |
collection | PubMed |
description | BACKGROUND: One-third of primary care providers (PCPs) refer patients with fibromyalgia or chronic pain (FM/CP) to specialist care, typically rheumatology. Yet, comprehensive data on the quality of rheumatology care for patients with FM/CP are currently lacking. METHODS: Records of patients referred for rheumatology consultation for FM/CP and seen at a single academic centre between 2017 and 2018 were extracted by retrospective chart review. Variables were diagnostic accuracy (at referral vs consultation), resource utilisation (investigations, medications, medical and allied health referral), direct costs (physician billing, staff salary, investigation fees) and access (consult wait time). Patient experience and referring PCP experience surveys were administered. RESULTS: 79 charts were identified. Following consultation, 81% of patients (n=64) maintained the same diagnosis of FM/CP, 19% (n=15) were diagnosed with regional pain and 0% of patients (n=0) were diagnosed with an inflammatory arthritis or connective tissue disease. Investigations were ordered for 37% of patients (n=29), medication prescribed for 10% (n=8) and an allied health referral provided for 54% (n=43). Direct costs totalled $19 745 (average $250/consult; range $157–$968/consult). Consultation wait time averaged 184 days (range 62–228 days). Out of the seven (64%) responses to the patient experience survey, 86% of patients (n=6) were satisfied with provider communication but the consultation ‘definitely’ met the expectations of only 57% (n=4). The PCP survey returned an insufficient response rate. CONCLUSIONS: This study found that no patient referred to rheumatology care for FM/CP was diagnosed with an inflammatory arthritis or connective tissue disease. Furthermore, patients with FM/CP experience lengthy wait times for rheumatology care which delay their management of chronic pain. Interdisciplinary and collaborative healthcare models can potentially provide higher quality care for patients with FM/CP. |
format | Online Article Text |
id | pubmed-7996658 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-79966582021-04-16 Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes Pang, Hilary YM Farrer, Chandra Wu, Wei Gakhal, Natasha K BMJ Open Qual Original Research BACKGROUND: One-third of primary care providers (PCPs) refer patients with fibromyalgia or chronic pain (FM/CP) to specialist care, typically rheumatology. Yet, comprehensive data on the quality of rheumatology care for patients with FM/CP are currently lacking. METHODS: Records of patients referred for rheumatology consultation for FM/CP and seen at a single academic centre between 2017 and 2018 were extracted by retrospective chart review. Variables were diagnostic accuracy (at referral vs consultation), resource utilisation (investigations, medications, medical and allied health referral), direct costs (physician billing, staff salary, investigation fees) and access (consult wait time). Patient experience and referring PCP experience surveys were administered. RESULTS: 79 charts were identified. Following consultation, 81% of patients (n=64) maintained the same diagnosis of FM/CP, 19% (n=15) were diagnosed with regional pain and 0% of patients (n=0) were diagnosed with an inflammatory arthritis or connective tissue disease. Investigations were ordered for 37% of patients (n=29), medication prescribed for 10% (n=8) and an allied health referral provided for 54% (n=43). Direct costs totalled $19 745 (average $250/consult; range $157–$968/consult). Consultation wait time averaged 184 days (range 62–228 days). Out of the seven (64%) responses to the patient experience survey, 86% of patients (n=6) were satisfied with provider communication but the consultation ‘definitely’ met the expectations of only 57% (n=4). The PCP survey returned an insufficient response rate. CONCLUSIONS: This study found that no patient referred to rheumatology care for FM/CP was diagnosed with an inflammatory arthritis or connective tissue disease. Furthermore, patients with FM/CP experience lengthy wait times for rheumatology care which delay their management of chronic pain. Interdisciplinary and collaborative healthcare models can potentially provide higher quality care for patients with FM/CP. BMJ Publishing Group 2021-03-24 /pmc/articles/PMC7996658/ /pubmed/33766832 http://dx.doi.org/10.1136/bmjoq-2020-001061 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Pang, Hilary YM Farrer, Chandra Wu, Wei Gakhal, Natasha K Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes |
title | Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes |
title_full | Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes |
title_fullStr | Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes |
title_full_unstemmed | Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes |
title_short | Quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes |
title_sort | quality of rheumatology care for patients with fibromyalgia and chronic pain syndromes |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996658/ https://www.ncbi.nlm.nih.gov/pubmed/33766832 http://dx.doi.org/10.1136/bmjoq-2020-001061 |
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