A patient and physician survey of fibromyalgia across Latin America and Europe

Patricia Clark,Anna Ginovker,Patricia Arline Salomón,Eduardo S Paiva

doi:10.1186/1471-2474-14-188

Abstract

BackgroundPatients and physicians from three Latin American (LA) and six European countries were surveyed in order to describe differences in journey to diagnosis, impact, and management of fibromyalgia (FM).Methods900 patients (300 LA; 600 Europe) and 1824 physicians (604 LA; 1220 Europe) were surveyed between October-December 2010 (LA) and February-April 2008 (Europe). Patients and physicians (GP or specialists) completed separate questionnaires, on symptoms, impact, and FM management. Interviews were conducted in local languages. Appropriate rating scales were used throughout. Data were analyzed using cross-tabulations and descriptive statistics. Significance was determined at P < 0.05 (indicated by *).ResultsIn LA versus Europe, patients reported having FM symptoms for longer (100.8 vs. 83.7* months), and taking longer to be diagnosed (42.3 vs. 31.1* months). FM was characterized by multiple symptoms (11.2 vs. 6.9), but more LA patients reported 14 common symptoms*, and rated pain higher on 11-point scale (8.0 vs. 7.2*). LA patients were taking fewer medications (3.3 vs. 4.0). Patients from both regions found common symptoms very/extremely disruptive to their quality of life, but symptoms impacted daily living and ability to work more significantly in LA. Physicians (GPs or specialists) from LA more often considered problems sleeping*, difficulty concentrating*, anxiety*, depression*, numbness/tingling*, and leg cramps* very/extremely disruptive vs. European physicians. Despite headache, heightened sensitivity to touch, difficulty concentrating, and joint pain being experienced by ≥50% of patients from both regions, <15% of PCPs or specialists considered these typical FM symptoms. Patients also considered 12/14 symptoms more disruptive than PCPs or specialists in the same region. However, a higher proportion of PCPs or specialists considered FM to have a strong/very strong impact on aspects of daily living vs. patients within the same region.ConclusionsPatient- and physician-rated disease perception and impact was often higher in LA than in Europe. Patient and physician perspective concerning FM impact and disruption were often misaligned within the same region. Our observations may be representative of cultural differences in stoicism, expression, beliefs, and attitudes to pain perception and management. Better understanding of these complexities could help targeted educational/training programs incorporating cultural differences, to improve chronic care.

Highlights

Patients and physicians from three Latin American (LA) and six European countries were surveyed in order to describe differences in journey to diagnosis, impact, and management of fibromyalgia (FM)
Prevalence estimates vary, with up to 5% of women reported to have FM from survey data in the US and across Europe [2,3,4], but some lower estimates have been presented from survey data of rheumatic diseases for other regions, such as certain Latin American countries [5,6,7,8,9]
Patient’s perspective of FM The study sample included 900 patients with a confirmed diagnosis of FM according to American College of Rheumatology (ACR) 1990 criteria [10]; 300 patients from Latin America (100 each from Mexico, Venezuela, Brazil), and 600 from Europe (100 each from UK, France, Germany, Italy, Spain, the Netherlands)

Summary

Introduction

Patients and physicians from three Latin American (LA) and six European countries were surveyed in order to describe differences in journey to diagnosis, impact, and management of fibromyalgia (FM). Guidelines for diagnosis and/or management of FM have been published by recognized bodies, such as the American College of Rheumatology (ACR) [1,10], and by bodies outside of the US [11,12,13]. Despite these protocols, FM is under-diagnosed and under-treated [14]. Hidden costs of disability and comorbidities associated with FM likely increase the true burden of FM even higher

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