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SAT0146 Results of four-years experience in fibromyalgia follow-up outpatient clinic
  1. Y Gursel,
  2. S Ergin,
  3. B Corekci
  1. Physical Medicine and Rehabilitation, University of Ankara, Faculty of Medicine, Ankara, Turkey

Abstract

Background Fibromyalgia, well-defined disease with widespread pain and tender points is still a challenge. Since it?s medically unexplained, the therapy remains empiric. So we need to assess our therapy results in longterm.

Objectives To determine the demographic, clinical properties with therapy results of patients followed in the Fibromyalgia Out-patient Follow-up Clinic (FOFC).

Methods In this study the records of the patients registered to FOFC were searched retrospectively. Records included demographic data, existing medical problems, symptoms related to fibromyalgia, VAS and Likert scale (0–4) for pain, scale scoring sleep disorder, number of tender points (TP), Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), Beck Depression Scale (BDS), laboratory assessments and therapy given. Patients were assessed by one trained researcher and by either one of the supervisors (YG, SE) at each visit. One hundred-twentythree records out of 166 were found to be eligible for analysis with sufficient data. SPSS 9.0 was used for statistical analysis.

Results Twenty-four patients (19,5%)(M = 3, F = 21) out of 123 were excluded with other diagnosis after initial assessment or after a few visits. Of these patients 95% had fatigue, 91% headache, 75% widespread pain, and 50% sleep disorder. Ninety-nine patients diagnosed as fibromyalgia were all female with mean age of 40,89 years, mean duration of symptoms 56,90 months. Eighty-one were married, 8 single and 9 widow, 21 had a job and 78 were housewives. The most common symptom was fatigue (99%) followed by widespread pain (91%), headache (84%), and sleep disorders (79%). Initial mean values for VAS was 72,26 mm, Likert scale was 2,71, number of TP was 14,02, HAQ was 8,74 and BDS was 16,64. VAS showed good correlation with Likert scale (r =, 619), 6th and 9th items of FIQ (r =, 453, r =, 418) but weak correlation with sleep scores, HAQ, interestingly no correlation with TP. Tender points did not show significant correlation with any other of the items. Patients were treated with TCAs and SSRIs, NSAID and analgesics were added when needed, physical therapy modalities, ROM, stretching and aerobic exercises were used in some patients or combined to other therapies. Overall analysis showed significant improvement in VAS (p =, 032), sleep scores (p =, 035), FIQ item rating fatigue (p =, 002), FIQ items rating tension (p =, 028) and depression (p =, 004) but not in TP between initial and last visits. When records were analysed case by case, resistant patients were detected and only a few patients were seemed to have a longtime improvement, and some triggering factors such as emotional trauma, minor disease such as flu etc. found to affect patients? symptoms.

Conclusion Diagnosis, assessment and follow-up of patients with fibromyalgia is not easy because of subjective, variable symptoms. Most of the patients seemed to have good times and bad times. Results of the short term outcomes may be good, but most of the patients did not maintain improvement in the longer term, they also needed to change the drug because of loss of efficacy or side effects and other treatment modalities were combined.

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