nach oben

Erschienen in:

05.03.2021 | Observational Research

Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective “real world” data analysis of fibromyalgia patients

verfasst von: Martin Offenbaecher, Niko Kohls, Thomas Ewert, Claudia Sigl, Robin Hieblinger, Loren L. Toussaint, Fuschia Sirois, Jameson Hirsch, Miguel A. Vallejo, Sybille Kramer, Javier Rivera, Gerold Stucki, Jörg Schelling, Andreas Winkelmann

Erschienen in: Rheumatology International | Ausgabe 11/2021

Einloggen, um Zugang zu erhalten

Abstract

Objective

To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM).

Methods

In this cross-sectional, observational study, “real world” data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses.

Results

The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (− 0.22), pain-related interference with everyday life (− 0.19), general activity (0.13), general health perception (0.11), punishing response from others (− 0.11), work status (− 0.10), vitality (− 0.11) and cognitive difficulties (− 0.12). Pain intensity or frequency was not an independent correlate.

Conclusions

More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P et al (1990) The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia Report of the Multicenter Criteria Committee. Arthritis Rheum 33(2):160–172CrossRefPubMed

Arnold LM, Crofford LJ, Mease PJ, Burgess SM, Palmer SC, Abetz L, Martin SA (2008) Patient perspectives on the impact of fibromyalgia. Patient Educ Couns 73(1):114–120. https://doi.org/10.1016/j.pec.2008.06.005CrossRefPubMedPubMedCentral

Henriksson C, Gundmark I, Bengtsson A, Ek AC (1992) Living with fibromyalgia consequences for everyday life. Clin J Pain 8(2):138–144CrossRefPubMed

Lempp HK, Hatch SL, Carville SF, Choy EH (2009) Patients' experiences of living with and receiving treatment for fibromyalgia syndrome: a qualitative study. BMC Musculoskelet Disord 10:124. https://doi.org/10.1186/1471-2474-10-124CrossRefPubMedPubMedCentral

Hoffman DL, Dukes EM (2008) The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12. Int J Clin Pract 62(1):115–126. https://doi.org/10.1111/j.1742-1241.2007.01638.xCrossRefPubMedPubMedCentral

Burckhardt CS, Clark SR, Bennett RM (1993) Fibromyalgia and quality of life: a comparative analysis. J Rheumatol 20(3):475–479PubMed

Offenbacher M, Sauer S, Kohls N, Waltz M, Schoeps P (2012) Quality of life in patients with fibromyalgia: validation and psychometric properties of the German Quality of Life Scale (QOLS-G). Rheumatol Int 32(10):3243–3252. https://doi.org/10.1007/s00296-011-2184-4CrossRefPubMed

Hawley DJ, Wolfe F (1991) Pain, disability, and pain/disability relationships in seven rheumatic disorders: a study of 1,522 patients. J Rheumatol 18(10):1552–1557PubMed

Bucourt E, Martaille V, Goupille P, Joncker-Vannier I, Huttenberger B, Reveillere C, Mulleman D, Courtois AR (2019) A comparative study of fibromyalgia, rheumatoid arthritis, Spondyloarthritis, and Sjogren’s Syndrome; impact of the disease on quality of life, psychological adjustment, and use of coping strategies. Pain Med. https://doi.org/10.1093/pm/pnz255CrossRef

10.

Karimi M, Brazier J (2016) Health, health-related quality of life, and quality of life: what is the difference? Pharmacoeconomics 34(7):645–649. https://doi.org/10.1007/s40273-016-0389-9CrossRefPubMed

11.

Ferrans CE, Zerwic JJ, Wilbur JE, Larson JL (2005) Conceptual model of health-related quality of life. J Nurs Scholarsh 37(4):336–342CrossRefPubMed

12.

Mason VL, Skevington SM, Osborn M (2004) Development of a pain and discomfort module for use with the WHOQOL-100. Qual Life Res 13(6):1139–1152CrossRefPubMed

13.

Cummins RA (2005) Moving from the quality of life concept to a theory. J Intellect Disabil Res 49(Pt 10):699–706. https://doi.org/10.1111/j.1365-2788.2005.00738.xCrossRefPubMed

14.

Ferrans CE (1990) Quality of life: conceptual issues. Semin Oncol Nurs 6(4):248–254CrossRefPubMed

15.

Ferrans CE (1996) Development of a conceptual model of quality of life. Sch Inq Nurs Pract 10(3):293–304PubMed

16.

Jones KD, Burckhardt CS, Deodhar AA, Perrin NA, Hanson GC, Bennett RM (2008) A six-month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia. Arthritis Rheum 58(2):612–622. https://doi.org/10.1002/art.23203CrossRefPubMedPubMedCentral

17.

Baranowsky J, Klose P, Musial F, Hauser W, Dobos G, Langhorst J (2009) Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatol Int 30(1):23. https://doi.org/10.1007/s00296-009-1120-3CrossRefPubMed

18.

Thorpe J, Shum B, Moore RA, Wiffen PJ, Gilron I (2018) Combination pharmacotherapy for the treatment of fibromyalgia in adults. Cochrane Database Syst Rev 2:010585. https://doi.org/10.1002/14651858.CD010585.pub2CrossRef

19.

Langhorst J, Klose P, Dobos GJ, Bernardy K, Hauser W (2013) Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Rheumatol Int 33(1):193–207. https://doi.org/10.1007/s00296-012-2360-1CrossRefPubMed

20.

Schiltenwolf M, Eidmann U, Kollner V, Kuhn T, Offenbacher M, Petzke F, Sarholz M, Weigl M, Wolf B, Hauser W (2017) Multimodal therapy of fibromyalgia syndrome: updated guidelines 2017 and overview of systematic review articles. Schmerz 31(3):285–288. https://doi.org/10.1007/s00482-017-0205-2CrossRefPubMed

21.

Kramer SDL, Kohls N, Offenbaecher M, Winkelmann A (2020) The importance of daily activity for reducing fibromyalgia symptoms: a retrospective, “real world” data comparison of two multimodal treatment programs. Arch Rheumatol 2:9–45

22.

Lautenschlager J, Seglias J, Bruckle W, Muller W (1991) Comparisons of spontaneous pain and tenderness in patients with primary fibromyalgia. Clin Rheumatol 10(2):168–173CrossRefPubMed

23.

Offenbaecher M, Waltz M, Schoeps P (2000) Validation of a German version of the fibromyalgia impact questionnaire (FIQ-G). J Rheumatol 27(8):1984–1988PubMed

24.

Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483CrossRefPubMed

25.

Bullinger M (1995) German translation and psychometric testing of the SF-36 health survey: preliminary results from the IQOLA Project. Internat Q Life Asses Soc Sci Med 41(10):1359–1366. https://doi.org/10.1016/0277-9536(95)00115-nCrossRef

26.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004CrossRefPubMed

27.

Hautzinger M (1991) The beck depression inventory in clinical practice. Nervenarzt 62(11):689–696PubMed

28.

Derogatis LR, Lipman RS, Covi L (1973) SCL-90: an outpatient psychiatric rating scale–preliminary report. Psychopharmacol Bull 9(1):13–28PubMed

29.

Franke GH (1995) Die Symptom-Checkliste von Derogatis (Deutsche Version). Göttingen (Germany), Beltz Test

30.

Rosenstiel AK, Keefe FJ (1983) The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain 17(1):33–44. https://doi.org/10.1016/0304-3959(83)90125-2CrossRefPubMed

31.

Hassett AL, Cone JD, Patella SJ, Sigal LH (2000) The role of catastrophizing in the pain and depression of women with fibromyalgia syndrome. Arthritis Rheum 43(11):2493–2500CrossRefPubMed

32.

Flor H, Rudy TE, Birbaumer N, Streit B, Schugens MM (1990) The applicability of the West Haven-Yale multidimensional pain inventory in German-speaking countries Data on the reliability and validity of the MPI-D. Schmerz 4(2):82–87CrossRefPubMed

33.

WHO (2001) International classification of functioning, disability and health: ICF. World Health Organization, Geneva

34.

Bickenbach JE, Chatterji S, Badley EM, Ustun TB (1999) Models of disablement, universalism and the international classification of impairments, disabilities and handicaps. Soc Sci Med 48(9):1173–1187 CrossRefPubMed

35.

Ewert T, Allen DD, Wilson M, Ustun B, Stucki G (2010) Validation of the international classification of functioning disability and health framework using multidimensional item response modeling. Disabil Rehabil 32(17):1397–1405. https://doi.org/10.3109/09638281003611037CrossRefPubMed

36.

Cieza A, Geyh S, Chatterji S, Kostanjsek N, Ustun B, Stucki G (2005) ICF linking rules: an update based on lessons learned. J Rehabil Med 37(4):212–218. https://doi.org/10.1080/16501970510040263CrossRefPubMed

37.

Neumann L, Berzak A, Buskila D (2000) Measuring health status in Israeli patients with fibromyalgia syndrome and widespread pain and healthy individuals: utility of the short form 36-item health survey (SF-36). Semin Arthritis Rheum 29(6):400–408CrossRefPubMed

38.

Silverman S, Sadosky A, Evans C, Yeh Y, Alvir JM, Zlateva G (2010) Toward characterization and definition of fibromyalgia severity. BMC Musculoskelet Disord 11:66. https://doi.org/10.1186/1471-2474-11-66CrossRefPubMedPubMedCentral

39.

Humphrey L, Arbuckle R, Mease P, Williams DA, Samsoe BD, Gilbert C (2010) Fatigue in fibromyalgia: a conceptual model informed by patient interviews. BMC Musculoskelet Disord 11:216. https://doi.org/10.1186/1471-2474-11-216CrossRefPubMedPubMedCentral

40.

Verbunt JA, Pernot DH, Smeets RJ (2008) Disability and quality of life in patients with fibromyalgia. Health Qual Life Outcomes 6:8. https://doi.org/10.1186/1477-7525-6-8CrossRefPubMedPubMedCentral

41.

Lame IE, Peters ML, Vlaeyen JW, Kleef M, Patijn J (2005) Quality of life in chronic pain is more associated with beliefs about pain, than with pain intensity. Eur J Pain 9(1):15–24. https://doi.org/10.1016/j.ejpain.2004.02.006CrossRefPubMed

42.

Bernard AL, Prince A, Edsall P (2000) Quality of life issues for fibromyalgia patients. Arthritis Care Res 13(1):42–50CrossRefPubMed

43.

Bossema ER, Kool MB, Cornet D, Vermaas P, de Jong M, van Middendorp H, Geenen R (2012) Characteristics of suitable work from the perspective of patients with fibromyalgia. Rheumatology (Oxford) 51(2):311–318. https://doi.org/10.1093/rheumatology/ker312CrossRef

44.

Uguz F, Cicek E, Salli A, Karahan AY, Albayrak I, Kaya N, Ugurlu H (2010) Axis I and Axis II psychiatric disorders in patients with fibromyalgia. Gen Hosp Psychiatry 32(1):105–107. https://doi.org/10.1016/j.genhosppsych.2009.07.002CrossRefPubMed

45.

Bradley LA (2009) Pathophysiology of fibromyalgia. Am J Med 122(12 Suppl):S22–30. https://doi.org/10.1016/j.amjmed.2009.09.008CrossRefPubMedPubMedCentral

46.

Bair MJ, Wu J, Damush TM, Sutherland JM, Kroenke K (2008) Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients. Psychosom Med 70(8):890–897. https://doi.org/10.1097/PSY.0b013e318185c510CrossRefPubMedPubMedCentral

47.

Galvez-Sanchez CM, Montoro CI, Duschek S, Reyes Del Paso GA (2020) Depression and trait-anxiety mediate the influence of clinical pain on health-related quality of life in fibromyalgia. J Affect Disord 265:486–495. https://doi.org/10.1016/j.jad.2020.01.129CrossRefPubMed

48.

Okifuji A, Turk DC, Sherman JJ (2000) Evaluation of the relationship between depression and fibromyalgia syndrome: why aren’t all patients depressed? J Rheumatol 27(1):212–219PubMed

49.

Park DC, Glass JM, Minear M, Crofford LJ (2001) Cognitive function in fibromyalgia patients. Arthritis Rheum 44(9):2125–2133CrossRefPubMed

50.

Suhr JA (2003) Neuropsychological impairment in fibromyalgia: relation to depression, fatigue, and pain. J Psychosom Res 55(4):321–329CrossRefPubMed

51.

Penninx BW, Guralnik JM, Bandeen-Roche K, Kasper JD, Simonsick EM, Ferrucci L, Fried LP (2000) The protective effect of emotional vitality on adverse health outcomes in disabled older women. J Am Geriatr Soc 48(11):1359–1366CrossRefPubMed

52.

Schaefer C, Chandran A, Hufstader M, Baik R, McNett M, Goldenberg D, Gerwin R, Zlateva G (2011) The comparative burden of mild, moderate and severe fibromyalgia: results from a cross-sectional survey in the United States. Health Qual Life Outcomes 9:71. https://doi.org/10.1186/1477-7525-9-71CrossRefPubMedPubMedCentral

53.

Da Costa D, Dobkin PL, Fitzcharles MA, Fortin PR, Beaulieu A, Zummer M, Senecal JL, Goulet JR, Rich E, Choquette D, Clarke AE (2000) Determinants of health status in fibromyalgia: a comparative study with systemic lupus erythematosus. J Rheumatol 27(2):365–372PubMed

54.

Soderberg S, Lundman B (2001) Transitions experienced by women with fibromyalgia. Health Care Women Int 22(7):617–631. https://doi.org/10.1080/07399330127169CrossRefPubMed

55.

Phillips LJ, Stuifbergen AK (2010) The relevance of depressive symptoms and social support to disability in women with multiple sclerosis or fibromyalgia. Int J Rehabil Res 33(2):142–150. https://doi.org/10.1097/MRR.0b013e3283310cceCrossRefPubMedPubMedCentral

56.

Calandre EP, Garcia-Carrillo J, Garcia-Leiva JM, Rico-Villademoros F, Molina-Barea R, Rodriguez-Lopez CM (2011) Subgrouping patients with fibromyalgia according to the results of the Fibromyalgia impact questionnaire: a replication study. Rheumatol Int 31(12):1555–1559. https://doi.org/10.1007/s00296-010-1521-3CrossRefPubMed

57.

Kurtze N, Gundersen KT, Svebak S (1999) Quality of life, functional disability and lifestyle among subgroups of fibromyalgia patients: the significance of anxiety and depression. Br J Med Psychol 72(Pt 4):471–484CrossRefPubMed

58.

Liedberg GM, Henriksson CM (2002) Factors of importance for work disability in women with fibromyalgia: an interview study. Arthritis Rheum 47(3):266–274. https://doi.org/10.1002/art.10454CrossRefPubMed

59.

Preece JC, Sandberg JG (2005) Family resilience and teh management of fibromyalgia: implications for family therapists. Contemorary Family Therapy 27:559–576CrossRef

60.

Steptoe A, Marmot M (2003) Burden of psychosocial adversity and vulnerability in middle age: associations with biobehavioral risk factors and quality of life. Psychosom Med 65(6):1029–1037CrossRefPubMed

61.

Lopez-Martinez AE, Esteve-Zarazaga R, Ramirez-Maestre C (2008) Perceived social support and coping responses are independent variables explaining pain adjustment among chronic pain patients. J Pain 9(4):373–379. https://doi.org/10.1016/j.jpain.2007.12.002CrossRefPubMed

62.

McCracken LM, Vowles KE, Eccleston C (2004) Acceptance of chronic pain: component analysis and a revised assessment method. Pain 107(1–2):159–166 CrossRefPubMed

63.

Van Wilgen CP, Kaptein AA, Brink MS (2010) Illness perceptions and mood states are associated with injury-related outcomes in athletes. Disabil Rehabil 32(19):1576–1585. https://doi.org/10.3109/09638281003596857CrossRefPubMed

64.

Kaptein AA, Klok T, Moss-Morris R, Brand PL (2010) Illness perceptions: impact on self-management and control in asthma. Curr Opin Allergy Clin Immunol 10(3):194–199. https://doi.org/10.1097/ACI.0b013e32833950c1CrossRefPubMed

65.

Hayes SM, Myhal GC, Thornton JF, Camerlain M, Jamison C, Cytryn KN, Murray S (2010) Fibromyalgia and the therapeutic relationship: where uncertainty meets attitude. Pain Res Management J Canadian Pain Society J Soc Can Trait Douleur 15(6):385–391

66.

Perrot S, Choy E, Petersel D, Ginovker A, Kramer E (2012) Survey of physician experiences and perceptions about the diagnosis and treatment of fibromyalgia. BMC Health Services Res 12:356. https://doi.org/10.1186/1472-6963-12-356CrossRef

Titel: Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective “real world” data analysis of fibromyalgia patients
verfasst von: Martin Offenbaecher
Niko Kohls
Thomas Ewert
Claudia Sigl
Robin Hieblinger
Loren L. Toussaint
Fuschia Sirois
Jameson Hirsch
Miguel A. Vallejo
Sybille Kramer
Javier Rivera
Gerold Stucki
Jörg Schelling
Andreas Winkelmann
Publikationsdatum: 05.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Rheumatology International / Ausgabe 11/2021
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-020-04702-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective “real world” data analysis of fibromyalgia patients

Abstract

Objective

Methods

Results

Conclusions

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin

Springer Medizin

Abstract

Objective

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2021

Methotrexate and interstitial lung disease. Is there a real causative factor?

Therapeutic education improves rheumatoid arthritis patients’ knowledge about methotrexate: a single center retrospective study

Factors associated with drug survival on first biologic therapy in patients with rheumatoid arthritis: a population-based cohort study

In the era of disease-modifying antirheumatic drugs, how close are we to treating rheumatoid arthritis without the use of glucocorticoids?

Beeinflusst COVID-19 die Fertilität und ist die Infektion sexuell übertragbar?

Esophageal dysmotility and lung disease in patients with systemic sclerosis: is there a possible association or correlation? A retrospective chart review

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin