Background/Purpose: Fibromyalgia is a chronic pain syndrome that commonly presents with fatigue, widespread musculoskeletal pain, and sleep disturbances. Patients can also have accompanying somatic and cognitive symptoms. According to National Fibromyalgia Association (NFA) it is estimated to affect around 10 million people every year in the U.S. It is more common in women (75-90%) but it can be seen in men and children as well. Fibromyalgia is usually under-recognized and the patients initially present to their primary care physicians when they start to develop symptoms. We did a cross-sectional survey to assess the knowledge of fibromyalgia diagnosis and management among Internal Medicine residents so that gaps can be identified, and intervention should be done through educational programs.

Methods: A 19-item questionnaire was prepared using current ACR and EULAR guidelines. A cross-sectional survey was conducted among residents from two residency programs in Chicago and Florida. The questionnaire included around 11 questions regarding the pathogenesis, diagnosis, and management of fibromyalgia. Other questions were mainly focused on how comfortable the residents are with diagnosing and managing fibromyalgia patients and the educational training they have received so far. Residents with 70% or more correct answers were considered to have good knowledge. The correct answers were compared to the number of teaching sessions and if the residents are familiar with recent guidelines.

Results: A total of 64 (64%) residents out of 100 completed the survey, only 34% (22) got a score of 70% or more and 41% scored 50% or less. Only 15% of the responders felt that they were adequately taught on the subject. Less than 30% of the responders felt comfortable diagnosing and managing fibromyalgia and only 18.8% of the residents have read the guidelines regarding it. Around 53% of the residents reported that they have not attended any teaching sessions on fibromyalgia. It was also found on the survey that less than 15% of the residents are familiar with FDA-approved medications for the treatment of fibromyalgia and the recent advances in the subject. About 50% of the residents who read the guidelines scored 70% or more as compared to around 30% of the residents who did not indicating that many residents need to familiarize themselves with the recent guidelines which can aid in the appropriate management of fibromyalgia. Another interesting finding in the results was that around 38% of PGY-1 residents got 70% of the questions right compared to 14.3% of PGY-2 residents and 42% of PGY-3 residents.

Conclusion: Our survey results suggest that there is a lack of knowledge among residents regarding the diagnosis and management of fibromyalgia. Therefore, teaching sessions aiming at these knowledge gaps can help in early recognition and better initial management of these patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-survey-on-fibromyalgia-related-knowledge-among-internal-medicine-residents/