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EC has received fees for consulting to Pfizer. SP has received fees for consulting to Pfizer. AG and EK are employed by Harris Interactive that was commissioned and funded by Pfizer Inc to develop and conduct the survey. The survey was commissioned and funded by Pfizer Inc, New York, NY. Janet Bray, MPharmS, provided medical writing services, which were funded by Pfizer Inc. Journal charges were also met by Pfizer Inc. Editorial support to prepare the manuscript for submission was provided by UBC Scientific Solutions and funded by Pfizer Inc.
All authors gave final approval of the version submitted for publication. SP and EC contributed to the interpretation of data, were involved in presenting the data and were involved in reviewing and critiquing the manuscript for important intellectual content. DL contributed to the interpretation of data and was involved in reviewing and critiquing the manuscript for important intellectual content. AG made substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data and was involved in reviewing and critiquing the manuscript for important intellectual content. EK made substantial contributions to the conception and design of the survey, interpretation of data and was involved in reviewing and critiquing the manuscript for important intellectual content. All authors read and approved the final manuscript.
Fibromyalgia (FM) is a condition characterized by widespread pain and is estimated to affect 0.5-5% of the general population. Historically, it has been classified as a rheumatologic disorder, but patients consult physicians from a variety of specialties in seeking diagnosis and ultimately treatment. Patients report considerable delay in receiving a diagnosis after initial presentation, suggesting diagnosis and management of FM might be a challenge to physicians.
A questionnaire survey of 1622 physicians in six European countries, Mexico and South Korea was conducted. Specialties surveyed included primary care physicians (PCPs; n=809) and equal numbers of rheumatologists, neurologists, psychiatrists and pain specialists.
The sample included experienced doctors, with an expected clinical caseload for their specialty. Most (>80%) had seen a patient with FM in the last 2 years. Overall, 53% of physicians reported difficulty with diagnosing FM, 54% reported their training in FM was inadequate, and 32% considered themselves not knowledgeable about FM. Awareness of American College of Rheumatology classification criteria ranged from 32% for psychiatrists to 83% for rheumatologists. Sixty-four percent agreed patients found it difficult to communicate FM symptoms, and 79% said they needed to spend more time to identify FM. Thirty-eight percent were not confident in recognizing the symptoms of FM, and 48% were not confident in differentiating FM from conditions with similar symptoms. Thirty-seven percent were not confident developing an FM treatment plan, and 37% were not confident managing FM patients long-term. In general, rheumatologists reported least difficulties/greatest confidence, and PCPs and psychiatrists reported greatest difficulties/least confidence.
Diagnosis and managing FM is challenging for physicians, especially PCPs and psychiatrists, but other specialties, including rheumatologists, also express difficulties. Improved training in FM and initiatives to improve patient-doctor communication are needed and may help the management of this condition.