Survey of physician experiences and perceptions about the diagnosis and treatment of fibromyalgiaReport as inadecuate

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BMC Health Services Research

, 12:356

First Online: 10 October 2012Received: 25 April 2011Accepted: 02 October 2012DOI: 10.1186-1472-6963-12-356

Cite this article as: Perrot, S., Choy, E., Petersel, D. et al. BMC Health Serv Res 2012 12: 356. doi:10.1186-1472-6963-12-356


BackgroundFibromyalgia 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.

MethodsA 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.

ResultsThe 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.

ConclusionsDiagnosis 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.

AbbreviationsACRAmerican College of Rheumatology

CATIComputer-assisted telephone interviewing

ENFAEuropean Network of Fibromyalgia Associations


PCPPrimary care physician

WHO ICD-10World Health Organization International Statistical Classification of Diseases and Related Health Problems, 10th Revision.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-12-356 contains supplementary material, which is available to authorized users.

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Author: Serge Perrot - Ernest Choy - Danielle Petersel - Anna Ginovker - Erich Kramer


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