Model of Care
Dr. Schiopu says this dissatisfaction with the healthcare system is probably warranted because the medical community still does not fully understand the pathophysiology behind the heterogeneous presentation of fibromyalgia and may demonstrate “medical animosity” to the patient. Although it’s not obvious these patients should be treated by rheumatologists, as opposed to pain specialists, patients with multi-system complaints, such as those seen in patients with fibromyalgia, are frequently referred to a rheumatologist, and thus, diagnosis and treatment of fibromyalgia are problems for rheumatologists.
Absent a good therapeutic option, Dr. Schiopu focuses on improving the patient’s quality of life, Patients may benefit from treatment from a psychologist and/or psychiatrist, she says.
This study delivers an important message, says Dr. Schiopu: Physicians need to be better at recognizing fibromyalgia and have access to a model of care for evidence-based approaches to manage fibromyalgia that will improve patient outcomes—particularly approaches for patients who wish to remain employed.
Dr. Schiopu also believes the diagnosis of fibromyalgia should be emphasized in the medical school curriculum. Until that happens, she says, “These patients end up bouncing back and forth.”
Lara C. Pullen, PhD, is a medical writer based in the Chicago area.
References
- Doebl S, Hollick RJ, Beasley M, et al. Comparing people who have and have not received a diagnosis of fibromyalgia: A cross-sectional survey within the PACFiND study. Arthritis Care Res (Hoboken). 2021 Jun 3. Online ahead of print.
- Macfarlane GJ, Beasley M, Scott NW, et al. Maintaining musculoskeletal health using a behavioral therapy approach: A population-based randomized controlled trial (The MamMOTH study). Ann Rheum Dis. 2021 Jul;80(7):903–911
- Wolfe F. New American College of Rheumatology criteria for fibromyalgia: A twenty-year journey. Arthritis Care Res (Hoboken). 2010 May;62(5):583–584.
- Wolfe F, Walitt B, Perrot S, et al. Fibromyalgia diagnosis and biases assessment: Sex, prevalence, and bias. PLoS One. 2018Sep 13;13(9):e0203755.
- Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014 Apr 16;311(15):1547–1555.
