Background/Purpose: Differences in healthcare practices around the world have been reported; however any impact on management of chronic conditions is often unclear. We surveyed patients and physicians from three Latin American (LA) and six European countries to ascertain differences in journey to diagnosis and management of fibromyalgia (FM).

Methods: Data from 900 FM patients (300 LA; 600 Europe) and 1824 GPs/specialists (604 LA; 1220 Europe) were collected between 2008 and 2010.Patients and physicians completed separate questionnaires, which included questions on symptoms (14 common symptoms), management, and impact of FM. Patient interviews (face-to-face or via telephone; ~25mins) were conducted in local languages (Spanish, Portuguese). Rating scales were used throughout. Data were analyzed using cross tabulations and descriptive statistics; no multivariate analysis. Significance determined at P<0.05 (indicated by *)

Results: Patients from LA reported FM symptoms for longer time (100.8 vs 83.7* months), took longer to be diagnosed (42.3 vs 31.1* months), and saw more physicians to receive a diagnosis (5.4 vs 4.0*) vs European patients, respectively. FM was characterized by multiple symptoms in both regions, although a higher proportion of patients from LA vs Europe reported common FM symptoms, including widespread pain (92% vs 62%*), sleep problems (84% vs 49%*), and fatigue (88% vs 46%*). Patients from LA rated their pain higher on a 10-point scale vs European patients (8.0 vs 7.2*). Patients from both regions reported common FM symptoms as disruptive to their quality of life (pain: 86% vs 78%*; sleeping problems: 80% vs 76%; fatigue: 80% vs 75%). Patients from LA more often reported that FM had impacted their ability to work and/or earn an income vs patients from Europe. LA patients were managed by different healthcare professionals, while European patients were mostly treated by GPs (47% vs 96%*). Physicians principally considered widespread pain as a typical FM symptom and being disruptive to patient’s. Although >50% of patients considered them common symptoms, <10% of GPs or specialists from either region considered problems sleeping or fatigue typical FM symptoms. Physicians from LA more often considered problems sleeping*, difficulty concentrating*, anxiety*, depression*, numbness/tingling*, and leg cramps* disruptive vs European physicians.

Conclusion: Differences between FM characteristics, treatment practices, and opinions were noted by physicians and patients from LA and Europe. Improved understanding of these complexities involved in FM in different healthcare settings may help target educational/training programs towards improving aspects of chronic care. Improving alignment between perception of FM from the patient and physician’s perspective may also improve patient management.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-patient-and-physician-survey-of-impact-and-management-of-fibromyalgia-across-latin-america-and-europe/