The impact of a diagnosis of fibromyalgia on health care resource use by primary care patients in the UK -: An observational study based on clinical practice
The impact of a diagnosis of fibromyalgia on health care resource use by primary care patients in the UK -: An observational study based on clinical practice
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DOI：
10.1002/art.21545
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发表时间：
2006-01-01
影响因子：
--
通讯作者：
Wessely, S
中科院分区：
文献类型：
--
作者：
Hughes, G;Martinez, C;Wessely, S
Objective.调查纤维肌痛（FM）诊断在临床实践中对英国医疗资源使用的影响。率的访问，处方，转诊，诊断检测估计在1998年至2003年3月在英国初级保健被诊断为FM的患者，并与匹配的对照组进行比较。从FM诊断前10年到诊断后4年，每隔6个月计算一次发生率。患者（2，260例）新诊断为FM; 81.3%为女性。他们的平均年龄是49岁。与对照组相比，FM患者在诊断前至少10年的就诊率、处方率和检测率显著较高。到诊断时，FM患者每年有25次就诊和11次处方，而对照组每年有12次就诊和4.5次处方。抑郁症的就诊率最高，其次是疲劳、胸痛、头痛和睡眠障碍。诊断后，大多数症状和卫生保健使用指标的就诊率下降，但在2-3年内，大多数就诊率上升到诊断时的水平或更高。被诊断为FM的初级保健患者在诊断前至少10年报告了更高的疾病和医疗资源使用率，这表明疾病行为可能起作用。被诊断为患有FM可能有助于患者科普一些症状，但从长远来看，诊断对医疗资源的使用影响有限，这可能是因为几乎没有有效的治疗方法。
Objective. To investigate the impact of a diagnosis of fibromyalgia (FM) in clinical practice on health care resource use in the UK.Methods. Rates of visits, prescriptions, referral, and diagnostic testing were estimated in patients who had been diagnosed as having FM between 1998 and March 2003 in UK primary care and compared with those in matched controls. Rates were calculated in 6-month intervals from 10 years before until 4 years after the FM diagnosis.Results. Patients (2,260) were newly diagnosed as having FM; 81.3% were women. Their mean age was 49 years. FM patients had considerably higher rates of visits, prescriptions, and testing from at least 10 years prior to diagnosis compared with controls. By the time of diagnosis, FM patients had 25 visits and 11 prescriptions per year compared with 12 visits and 4.5 prescriptions per year in controls. Visit rates were highest for depression, followed by fatigue, chest pain, headache, and sleep disturbance. Following diagnosis, visits for most symptoms and health care use markers declined, but within 2-3 years, most visits rose to levels at or higher than those at diagnosis.Conclusion. Primary care patients who had been diagnosed as having FM reported higher rates of illness and health care resource use for at least 10 years prior to their diagnosis, which suggests that illness behavior may play a role. Being diagnosed as having FM may help patients cope with some symptoms, but the diagnosis has a limited impact on health care resource use in the longer term, possibly because there is little effective treatment.