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Agarwal A, Emary PC, Gallo L, Oparin Y, Shin SH, Fitzcharles MA, Adachi JD, Cooper MD, Craigie S, Rai A, Wang L, Couban RJ, Busse JW. Physicians' knowledge, attitudes, and practices regarding fibromyalgia: A systematic review and meta-analysis of cross-sectional studies. Medicine (Baltimore) 2024; 103:e39109. [PMID: 39093781 PMCID: PMC11296454 DOI: 10.1097/md.0000000000039109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The diagnosis, etiology, and optimal management of fibromyalgia remains contentious. This uncertainty may result in variability in clinical management. We conducted a systematic review and meta-analysis of cross-sectional studies examining physicians' knowledge, attitudes, and practices regarding fibromyalgia. METHODS We searched MEDLINE, Embase, and PubMed from inception to February 2023 for cross-sectional surveys evaluating physicians' attitudes toward, and management of, fibromyalgia. Pairs of independent reviewers conducted article screening, data extraction, and risk of bias assessment in duplicate. We used random-effects meta-analysis to pool proportions for items reported by more than one study and the Grading of Recommendations Assessment, Development, and Evaluation approach to summarize the certainty of evidence. RESULTS Of 864 citations, 21 studies (8904 participants) were eligible for review. Most physicians endorsed fibromyalgia as a distinct clinical entity (84%; 95% confidence interval [CI], 74-92), and half (51%; 95% CI, 40-62) considered fibromyalgia a psychosocial condition. Knowledge of formal diagnostic criteria for fibromyalgia was more likely among rheumatologists (69%, 95% CI, 45-89) versus general practitioners (38%, 95% CI, 24-54) (P = .04). Symptom relief was endorsed as the primary management goal by most physicians (73%, 95% CI, 52-90). Exercise, physiotherapy, antidepressants, nonsteroidal anti-inflammatory drugs, and non-opioid analgesics were most endorsed for management of fibromyalgia, but with wide variability between surveys. Opioids and most complementary and alternative interventions (e.g., homeopathy, chiropractic, and massage) received limited endorsement. CONCLUSION There is moderate certainty evidence to suggest that physicians are divided regarding whether fibromyalgia is a biomedical or psychosocial disorder. Physicians typically prioritize symptom relief as the primary goal of management, and often endorse management with exercise, non-opioid analgesics, nonsteroidal anti-inflammatory drugs, antidepressants, and physiotherapy (moderate to high certainty evidence); however, important practice variation exists.
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Affiliation(s)
- Arnav Agarwal
- School of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Peter C. Emary
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
- Department of Chiropractic, D’Youville University, Buffalo, NY
| | - Lucas Gallo
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Yvgeniy Oparin
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Sae Ha Shin
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Jonathan D. Adachi
- Hamilton Arthritis Centre, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Matthew D. Cooper
- Department of Rheumatology, University of Calgary, Calgary, Alberta, Canada
| | - Samantha Craigie
- Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
| | - Arjun Rai
- Department of Chiropractic, D’Youville University, Buffalo, NY
| | - Li Wang
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Rachel J. Couban
- Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
| | - Jason W. Busse
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
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Schweiger V, Martini A, Nizzero M, Bonora E, Del Balzo G, Gottin L, Torroni L, Polati L, Zuliani G, Secchettin E, Polati E. Prevalence of FMS Diagnosis According to ACR 2016 Revised Criteria in a Pain Therapy Centre in Italy: Observational Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:599. [PMID: 38674245 PMCID: PMC11052143 DOI: 10.3390/medicina60040599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Fibromyalgia syndrome (FMS) is a multifaceted disease with a strong preference for the female sex. It is characterised by chronic widespread pain, sleep-wake disorders, fatigue, cognitive disturbances, and several other somatic symptoms. Materials and Methods: In this prospective observational study, we analysed data regarding 302 patients who were referred to our pain centre for a first clinical assessment evaluation and were then inspected for the physician-based 2016 revision of the ACR diagnostic criteria for FMS, regardless of the final diagnosis previously made by the pain therapist. Results: Among the 280 patients who adhered to the 2016 ACR questionnaire, 20.3% displayed positive criteria for FMS diagnosis. The level of agreement between the FMS discharge diagnosis made by the pain clinician and the ACR 2016 criteria-positivity was moderate (kappa = 0.599, with moderate agreement set at a kappa value of 0.6). Only four patients (1.7%) diagnosed as suffering from FMS at discharge did not satisfy the minimal 2016 ACR diagnostic criteria. Conclusions: This prospective observational study confirmed the diagnostic challenge with FMS, as demonstrated by the moderate grade of agreement between the FMS diagnosis at discharge and the positivity for 2016 ACR criteria. In our opinion, the use of widely accepted diagnostic guidelines should be implemented in clinical scenarios and should become a common language among clinicians who evaluate and treat patients reporting widespread pain and FMS-suggestive symptoms. Further methodologically stronger studies will be necessary to validate our observation.
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Affiliation(s)
- Vittorio Schweiger
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Alvise Martini
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Marta Nizzero
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Eleonora Bonora
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Giovanna Del Balzo
- Department of Diagnostics and Public Health, Section of Forensic Medicine, University of Verona, 37134 Verona, Italy;
| | - Leonardo Gottin
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Lorena Torroni
- Department of Diagnostics and Public Health, Unit of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy;
| | - Luca Polati
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Giada Zuliani
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Erica Secchettin
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
| | - Enrico Polati
- Anesthesiology, Intensive Care and Pain Therapy Centre, Department of Surgery, Dentistry and Maternal Sciences, University of Verona, 37124 Verona, Italy; (A.M.); (M.N.); (E.B.); (L.G.); (L.P.); (G.Z.); (E.S.); (E.P.)
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Alatawi A, Moria HA, Alharfy AA, Sehly MJ, Alotaibi JTA, Alshammari YS, Albalawi AOA, Alanazi SM, Sehly AJ. Knowledge, Attitude, and Practice Regarding Fibromyalgia Among Primary Care Physicians in Tabuk, Saudi Arabia. Cureus 2023; 15:e35097. [PMID: 36945290 PMCID: PMC10024889 DOI: 10.7759/cureus.35097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Adequately informed family physicians have the greatest potential to correctly identify the diagnosis of fibromyalgia (FM) and develop an initial treatment plan. Therefore, it is substantial to determine the levels of weakness and inaccuracy among primary care physicians regarding FM diagnostic criteria and management strategies. AIM This study aimed to assess the knowledge, attitude, and practices regarding FM among primary care physicians in Tabuk, Saudi Arabia. METHODS This cross-sectional study included family physicians who were board-certified or registered in the family medicine training program and working at the government family healthcare centers in Tabuk. A pre-designed, structured questionnaire was distributed either in written form or as an online survey. RESULTS This study included 52 primary healthcare physicians. Twenty-two (42.3%) participants incorrectly recorded localized pain as a diagnostic symptom, and 45 (86.5%) incorrectly recorded nonsteroidal anti-inflammatory drugs (NSAIDs), prednisolone, and/or opioids as drugs that are used for treating FM. Only 59.6% were confident in recognizing the symptoms of FM, and 55.8% were confident in differentiating FM from other similar diseases. CONCLUSIONS The primary healthcare physicians working in the government's primary healthcare centers in Tabuk City, Saudi Arabia, have low levels of knowledge about diagnostic criteria and treatment strategies for FM. These findings highlight the need for continuous professional development involving family physicians in the primary healthcare setting with suitable continuous medical education (CME) programs concerning FM.
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Affiliation(s)
- Amirah Alatawi
- Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, SAU
| | - Hassan A Moria
- Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, SAU
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Hyder Zaidi ST, Ashraf H, Javaid SS, Rashid AM, -Haque SU, Fatima SS, Ali NM. Survey of knowledge and attitude towards fibromyalgia among physicians in Karachi, Pakistan. Br J Pain 2022; 16:593-600. [PMID: 36452123 PMCID: PMC9703244 DOI: 10.1177/20494637221106658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Objectives Our study aims to assess knowledge and understanding of FM among doctors employed at a tertiary care hospital in Karachi, Pakistan with a focus on its diagnostic criteria, treatment modalities, and general knowledge of symptoms. Study Design Cross-sectional Study. Methods Our cross-sectional study recruited participants through convenience sampling. A total of 104 participants responded, which included (a) House Officers, (b) Medical Officers, and (c) Residents. A structured questionnaire was used, and an electronic form was generated which was then emailed to the participants to acquire their responses. Results The majority (66.3%) of our respondents were female and the median age was 26 years. A majority (93.3%) accepted FM as a separate and distinct clinical identity, and 79.8% were confident in recognizing its general symptoms. Widespread pain (95.2%) and fatigue (80.8%) were correctly identified as most commonly observed symptoms. Moreover, 68.3% of respondents possessed no knowledge of both ACR 1990 and 2010 diagnostic criteria for FM. Of those aware, majority favored using the most recent ACR 2010 criteria (72.7%). Majority of our respondents (75%) preferred using pharmaceutical and non-pharmaceutical interventions simultaneously in the treatment. Conclusions Our study indicates that while physicians have satisfactory knowledge of the symptoms and treatment modalities of FM, a knowledge gap concerning its diagnostic criteria exists. Proper treatment can only be successful when physicians successfully diagnose FM, therefore, future training programs should use this fact as a stepping stone for advances in its healthcare.
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Affiliation(s)
| | - Hira Ashraf
- Department of Physiology, Foundation University, Islamabad, Pakistan
| | - Syed Sarmad Javaid
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | | | - Shajee-Ul -Haque
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Syeda Sidra Fatima
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Nouman Mansoor Ali
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
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Valenzuela-Pascual F, Pàmies-Fabra J, García-Martínez E, Martínez-Navarro O, Climent-Sanz C, Gea-Sánchez M, Virgili-Gomà J, Rubí-Carnacea F, Garcia-Escudero M, Blanco-Blanco J. Use of a gamified website to increase pain neurophysiology knowledge and improve satisfaction and motivation among students studying for a degree in physiotherapy: a quasi-experimental study. BMC MEDICAL EDUCATION 2022; 22:389. [PMID: 35596174 PMCID: PMC9123810 DOI: 10.1186/s12909-022-03457-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The scientific evidence highlights the difficulties that healthcare professionals experience when managing patients with chronic pain. One of the causes of this difficulty could be related to the acquired training and the lack of knowledge about the neurophysiology of pain. In the present study, we assessed the effectiveness of a gamified web platform in acquiring knowledge about pain neurophysiology and determining the satisfaction and motivation of students of the Degree in Physiotherapy at the University of Lleida. METHODS A quasi-experimental study was carried out with a sample of 60 students who had access to a gamified web platform that included notes, videos, and clinical cases prepared by the teaching staff and was based on a previous study that included patients and healthcare professionals. RESULTS The results show that after the intervention, there was a statistically significant increase in knowledge about the neurophysiology of pain, and the effect size was in the desired area of effect. Likewise, many students considered that their motivation had increased as a result of the methodology used in the present study. CONCLUSIONS The results support the use of this methodology to promote knowledge about the neurophysiology of pain while improving students' motivation.
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Affiliation(s)
- Fran Valenzuela-Pascual
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain
- Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Judith Pàmies-Fabra
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain
| | - Ester García-Martínez
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain.
- Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain.
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain.
| | - Oriol Martínez-Navarro
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Carolina Climent-Sanz
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain
- Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain
- Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Jordi Virgili-Gomà
- Department of Computer Science and Industrial Engineering, The University of Lleida, Lleida, Spain
| | - Francesc Rubí-Carnacea
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain
- Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Maria Garcia-Escudero
- Faculty of Medicine and Health Sciences, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - Joan Blanco-Blanco
- Department of Nursing and Physiotherapy, The University of Lleida, Montserrat Roig, 2, 25198, Lleida, Spain
- Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
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Zeid W, Ibrahim M. Assessment of family physicians' knowledge about fibromyalgia in Egypt. THE EGYPTIAN RHEUMATOLOGIST 2021. [DOI: 10.1016/j.ejr.2020.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mendoza-Muñoz M, Rodal M, García-Gordillo MÁ, Acevedo-Duque Á, García-Matador J, Calzada-Rodríguez JI, Morenas-Martín J. Spanish Translation and Cultural Adaptation of the Fibromyalgia Knowledge Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7678. [PMID: 34300129 PMCID: PMC8305758 DOI: 10.3390/ijerph18147678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Fibromyalgia (FM) translates into a reduction in the quality of life of people who suffer from it, being a chronic disease of unknown etiology. One of the most widespread treatments includes the combination of patient education, along with other components. At the educational level, the Fibromyalgia Knowledge Questionnaire (FKQ) is a tool that assesses knowledge of fibromyalgia. OBJECTIVE To obtain the translation and cultural adaptation of the FKQ questionnaire into Spanish, as well as its readability, in addition to knowing the relationship between knowledge of the disease and the level of disability. METHOD In phase one, a translation-back translation and an evaluation of the readability of the questionnaire was carried out from INFLESZ, while in phase two, the questionnaire was passed to women with FM to detect their knowledge of the disease. A total of 49 women participated, with a mean age of 54.48 years. RESULTS The Spanish version of the FKQ questionnaire was rated by the participants in all its items as "clear and understandable". The readability obtained by the questionnaire was similar to its original version, with both totals being in the "normal" range, following the INFLESZ ranges. Regarding the patients' knowledge about FM, the component in which the highest score was obtained was physical activity (80% correct), while the one that obtained the worst score was knowledge about medication (50% correct). In addition, an inverse correlation was obtained between the FKQ and the FIQ (Fibromyalgia Impact Questionnaire) (r = -0.438; p < 0.01). CONCLUSIONS The FKQ has been translated and culturally adapted, obtaining a correct understanding by the participants, as well as a degree of readability similar to the original questionnaire. Furthermore, it was obtained that, the lower the level of knowledge of the sick person, the greater the disability.
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Affiliation(s)
- María Mendoza-Muñoz
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.M.-M.); (J.G.-M.); (J.I.C.-R.)
| | - Miguel Rodal
- BioErgon Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | | | | | - Judith García-Matador
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.M.-M.); (J.G.-M.); (J.I.C.-R.)
| | - José Ignacio Calzada-Rodríguez
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.M.-M.); (J.G.-M.); (J.I.C.-R.)
| | - Jesús Morenas-Martín
- Motor Control Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
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Mendoza-Muñoz M, Morenas-Martín J, Rodal M, García-Matador J, García-Gordillo MÁ, Calzada-Rodríguez JI. Knowledge about Fibromyalgia in Fibromyalgia Patients and Its Relation to HRQoL and Physical Activity. BIOLOGY 2021; 10:673. [PMID: 34356528 PMCID: PMC8301415 DOI: 10.3390/biology10070673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/24/2022]
Abstract
Introduction: Fibromyalgia (FM) affects 2.40% of the Spanish population. The most widespread treatment has been the combination of patient education, pain coping strategies and exercise. With regard to patient education, there are few previous studies on the efficacy of relating FM education in isolation with an improvement in FM, although there are some studies that report that health education programs could modify the perception of quality of life and improve pain. Objectives: the aim was to find out the level of knowledge about FM among patients in Extremadura, to explore the relationship between knowledge of FM and Health-Related Quality of Life (HRQoL) and to analyze the relationship between knowledge of physical activity in FM and the practice of physical activity. Methods: A single-measure cross-sectional study was carried out with 121 women with a mean age of 55.06 (±9.93) years. The following questionnaires were used: Fibromyalgia Knowledge Questionnaire (FKQ); SF12v2 (Short-Form Health Survey); and EURO-QOL-5D-5L (EQ-5D-5L). Results: regarding the level of knowledge of the participants about FM, it was found that 10% had a low knowledge, 49% medium and 41% high. In relation to the associations between the level of knowledge and HRQoL, a weak correlation between EQ-5D-5L and the FKQ in the domain of physical activity (r = 0.243) were found. Conclusions: it can be concluded that the level of knowledge about FM of the patients from Extremadura was medium-high and that there is a direct weak relationship between knowledge about physical activity in FM and HRQoL. However, no association was found between knowledge of physical activity in FM and the practice of physical activity.
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Affiliation(s)
- María Mendoza-Muñoz
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain; (M.M.-M.); (J.G.-M.); (J.I.C.-R.)
| | - Jesús Morenas-Martín
- Motor Control Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Miguel Rodal
- BioErgon Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain;
| | - Judith García-Matador
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain; (M.M.-M.); (J.G.-M.); (J.I.C.-R.)
| | | | - José Ignacio Calzada-Rodríguez
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain; (M.M.-M.); (J.G.-M.); (J.I.C.-R.)
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Fibromyalgia: the underdiagnosed disease of pain. Reumatologia 2021; 59:64. [PMID: 33707799 PMCID: PMC7944961 DOI: 10.5114/reum.2021.103452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/18/2021] [Indexed: 11/17/2022] Open
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Kaki AM, Hazazi AA. Assessment of medical practitioners' knowledge of fibromyalgia in Saudi Arabia. Saudi J Anaesth 2018; 12:178-182. [PMID: 29628824 PMCID: PMC5875202 DOI: 10.4103/sja.sja_458_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Fibromyalgia (FM), a relatively common disease, is difficult to diagnose owing to its subjective symptoms and poor knowledge among medical practitioners. The purpose of this study was to assess the knowledge regarding FM among medical practitioners in Saudi Arabia and the need for educational programs at the undergraduate level. Subjects and Methods: An online survey was administered to physicians, nurses, and technologist/technicians in different regions of the country. Responses were obtained from 104 medical practitioners. Knowledge regarding FM including clinical symptoms, diagnosis, and treatment was assessed. Results: Only 26% of the respondents reported that FM was part of their undergraduate curriculum, and only 8.7% attended educational programs about FM. (Approximately 50% of the medical practitioners either referred FM patients to unrelated specialty or did not know whom to refer these patients to). Only 33.7% of the respondents were familiar with the diagnostic criteria. Physiotherapy (69.4%) and pharmacological treatment (63.9%) were predominantly reported as the appropriate treatment. Conclusions: Knowledge regarding FM among medical practitioners in Saudi Arabia is poor. Further education at the undergraduate level is needed to improve knowledge and avoid delays in diagnosis and treatment.
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Affiliation(s)
- Abdullah Mohammad Kaki
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdulaziz A Hazazi
- Department of Anesthesia, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
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Kumbhare D, Ahmed S, Watter S. A narrative review on the difficulties associated with fibromyalgia diagnosis. Ther Adv Musculoskelet Dis 2018; 10:13-26. [PMID: 29290763 PMCID: PMC5724646 DOI: 10.1177/1759720x17740076] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/11/2017] [Indexed: 11/17/2022] Open
Abstract
Fibromyalgia presents a clinical enigma as its pathophysiology is not well understood and its symptoms are nonspecific and overlap with many disorders, making its diagnosis a challenge for clinicians and researchers. Efforts have been made to develop a set of diagnostic criteria for this disorder. However, these criteria rely heavily on expert clinician opinion and produce a large heterogeneity within the diagnosed population. With no present specific technique reflecting the underlying pathophysiology of fibromyalgia, a definitive diagnosis of fibromyalgia remains elusive. This review discusses some problems and challenges associated with fibromyalgia diagnosis and presents some novel findings on the pathophysiological nature of fibromyalgia.
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Affiliation(s)
- Dinesh Kumbhare
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Toronto Rehabilitation Institute, 550 University Avenue, Toronto, ONT, Canada M5G 2A2
| | - Sara Ahmed
- Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Scott Watter
- Department of Psychology, McMaster University, Hamilton, ON, Canada
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Knowledge on fibromyalgia among general practitioners, from Chiclayo-Peru, 2016. ACTA ACUST UNITED AC 2016; 13:326-330. [PMID: 27742549 DOI: 10.1016/j.reuma.2016.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/12/2016] [Accepted: 08/13/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Knowledge about fibromyalgia in general practitioners in the province of Chiclayo, Peru, 2016. MATERIALS AND METHODS Cross sectional descriptive study. Non-probability sampling, census type. In all, 145 physicians were evaluated through a questionnaire of 14 questions, validated by experts and a pilot. The analysis was performed using STATA v. 13. RESULTS Accuracy in questions involving diagnosis was 41.1% and in questions about treatment: 65%; 75.1% 'had seen patients with fibromyalgia' previously. The average on locating pain points was 2.2±2.8. Only 2.8% identified 11 or more painful points; 54.5% answered that 'the diagnosis is clinical and exams are for the differential diagnosis'; 46.1% in Ministerio de Salud (MINSA) and 28.3% in Seguro Social de Salud (EsSalud) answered the item about diagnostic criteria (P=.021); 65.7% said that psychotherapy, pregabalin and aerobic exercise were the most effective therapeutic triad, with no differences between MINSA and EsSalud: 61.5% vs. 68.6% (P=.23); 59.3% responded that drugs that had proved to be useful were: Pregabalin, duloxetine and amitriptyline; 66.2% responded that the most effective physical therapy is aerobic exercise. CONCLUSIONS Knowledge of the diagnosis and treatment of fibromyalgia by general doctors in Chiclayo is poor. There are some differences in knowledge depending on the age and type of institution to which each belongs.
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Gumà-Uriel L, Peñarrubia-María MT, Cerdà-Lafont M, Cunillera-Puertolas O, Almeda-Ortega J, Fernández-Vergel R, García-Campayo J, Luciano JV. Impact of IPDE-SQ personality disorders on the healthcare and societal costs of fibromyalgia patients: a cross-sectional study. BMC FAMILY PRACTICE 2016; 17:61. [PMID: 27245582 PMCID: PMC4888611 DOI: 10.1186/s12875-016-0464-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 05/20/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Data is lacking on comorbid personality disorders (PD) and fibromyalgia syndrome (FMS) in terms of prevalence, and associated healthcare and societal costs. The main aim of this study was to assess the prevalence of PD in FMS patients and to analyse whether the presence of comorbid PD is related to worse functional impairment and greater healthcare (medical visits, drug consumption, and medical tests) and societal costs. METHODS A cross-sectional study was performed using the baseline data of 216 FMS patients participating in a randomized, controlled trial carried out in three primary health care centres situated in the region of Barcelona, Spain. Measurement instruments included the International Personality Disorder Examination - Screening Questionnaire (IPDE-SQ), the Fibromyalgia Impact Questionnaire (FIQ), the Client Service Receipt Inventory (CSRI), and a socio-demographic questionnaire. RESULTS Most patients (65 %) had a potential PD according to the IPDE-SQ. The most prevalent PD were the avoidant (41.4 %), obsessive-compulsive (33.1 %), and borderline (27 %). We found statistically significant differences in functional impairment (FIQ scores) between FMS patients with potential PD vs non-PD (59.2 vs 51.1; p < 0.001). Multivariate regression analyses revealed that higher FIQ total scores and the presence of potential PD were related to more healthcare costs (primary and specialised care visits). CONCLUSIONS As expected, PD are frequent comorbid conditions in patients with FMS. Our results suggest that the screening of comorbid PD in patients with FMS might be recommendable in order to detect potential frequent attenders to primary and specialised care.
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Affiliation(s)
- Laura Gumà-Uriel
- Mental Health Centre Esplugues, Parc Sanitari Sant Joan de Déu, Rambla Verge de la Mercé, 1 edif. Molí. 08950, Esplugues Sant Boi del Llobregat, Esplugues del Llobregat, Spain.
| | - M Teresa Peñarrubia-María
- Primary Health Centre Bartomeu Fabrés Anglada, SAP Delta Llobregat, Unitat Docent Costa de Ponent, Institut Català de la Salut, Gavà, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain
| | - Marta Cerdà-Lafont
- Teaching, Research, & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Oriol Cunillera-Puertolas
- Unitat de Suport a la Recerca, IDIAP Jordi Gol, Primary Health care Department of Costa de Ponent, Institut Català de la Salut, Cornellà de Llobregat, Spain
| | - Jesús Almeda-Ortega
- Unitat de Suport a la Recerca, IDIAP Jordi Gol, Primary Health care Department of Costa de Ponent, Institut Català de la Salut, Cornellà de Llobregat, Spain
| | - Rita Fernández-Vergel
- Primary Health Centre Bartomeu Fabrés Anglada, SAP Delta Llobregat, Unitat Docent Costa de Ponent, Institut Català de la Salut, Gavà, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain
| | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain.,Department of Psychiatry, Miguel Servet Hospital, Aragon Institute of Health Sciences (I + CS), Zaragoza, Spain
| | - Juan V Luciano
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain.,Teaching, Research, & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Open University of Catalonia, Barcelona, Spain
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