Psychiatry Medical News about Fibromyalgia; Health Care Use; Costs

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Comparison of health care use and costs in newly diagnosed and established patients with fibromyalgia
The Journal of Pain, 06/30/09

White LA et al. – Study reports that established fibromyalgia patients use more medical resources and have higher rates of concomitant medication use than newly diagnosed fibromyalgia patients. Findings can help educate providers regarding optimal drug treatment patterns in this population.

Methods

Claims database analysis to describe prescription and medical use in pts with newly diagnosed and established fibromyalgia
Privately insured pts with 2+ myalgia/myositis claims (1999-2005) were categorized as newly diagnosed or established
This dichotomy involves comparisons between prediagnosis (S1) and postdiagnosis (S2) stages in the newly diagnosed and between newly diagnosed (S2) and established patients (S3)

Results

Use of APS guideline medications increased across stages:
- Selective serotonin reuptake inhibitors (SSRIs) (S1, S2, S3: 20.6%, 22.9%, 25.3%)
- Serotonin norepinephrine reuptake inhibitors (SNRIs) (4.5%, 6.4%, 8.9%)
- Pregabalin/gabapentin (5.4%, 7.4%, 8.8%)
- Benzodiazepines (19.0%, 21.1%, 24.2%)
- Non-benzodiazepine sedatives (9.1%, 11.5%, 13.7%), and
- Opioids (39.5%, 43.3%, 43.9%)
Use of multiple therapeutic classes also increased across stages: 3+ classes (7.1%, 9.6%, 11.8%)
Office visits to providers increased, on average, after diagnosis:
- Primary care (70.9%, 78.3%, 76.3%)
- Chiropractors (28.8%, 51.1%, 53.3%)
- Rheumatologists (4.2%, 9.9%, 10.5%)
- Mental health (6.4%, 7.3%, 8.3%)
Average health care costs rose after diagnosis in the newly diagnosed group