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Significant health care resource use, comorbidities common in patients with FM
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Significant differences in the use of health care resources and the number of comorbidities existed between patients with and without fibromyalgia, according to recently published research.
Researchers studied deidentified patient information from the Humedica database of more than 9 million people with commercial health insurance, Medicaid or Medicare between 2011 and 2012 and identified 4,296 patients with fibromyalgia (FM). Patients included in the study had two ICD-9 codes in health records 30 days apart during 2012 and were older than 18 years of age. Patients were excluded in the presence of malignancy, organ transplantation, residence in a nursing facility during the study period or diagnosis of FM prior to 2012. Patients with FM were compared with 583,665 patients in the database who were not diagnosed with FM.
Significant differences were seen between the two cohorts, according to the researchers. Patients with fibromyalgia were more likely to be women (78.7% vs. 64.5%), more likely to be white (87.9% vs. 73.7%) and more likely to have a higher Charlson Comorbidity index score.
Univariate analysis showed the presence of systemic lupus erythematosus resulted in the highest likelihood for FM, with an odds ratio (OR) of 4.7. Patients with mixed connective tissue disorder had an OR of 4.5 for FM, and patients with temporomandibular joint disorder or PTSD had an OR of 4.4 for FM.
The presence of any musculoskeletal condition or neuropathic pain condition present was associated with an OR of 3.1 for FM. Nearly three times as many patients with rheumatoid arthritis had FM, and almost twice as many patients with FM had osteoarthritis compared with patients without FM, according to the researchers.
The researchers found that health care resource utilization was higher in patients with FM. The highest likelihood of FM was seen in patients who had laboratory tests ordered (OR 5.8), followed by outpatient visits (OR 4.8) and administration of opioid prescriptions (OR 4.6), which occurred 3.9 times more often in patients with FM. In units of resources used per patient, patients with FM scored higher in usage, with the greatest difference seen in the number of prescriptions administers (15.1 per patient with FM vs. 6.6 in patients without FM).
Other comorbidities, such as dyspareunia, were associated with a more than threefold likelihood of being associated with a diagnosis of FM, whereas chest pain, memory loss, involuntary movements and obesity had a two- to fourfold increased likelihood of an FM association, according to the researchers. – by Shirley Pulawski
Disclosures: The research was sponsored by Pfizer and Masters is an employee and shareholder of Pfizer. Please see the full study for a list of all other authors’ relevant financial disclosures.
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