Background/Purpose Patients with fibromyalgia (FM) experience pain, sleep disruption, fatigue, and other symptoms that limit activity, impacting work productivity and increasing healthcare utilization. Here, we describe the burden of FM on work productivity and healthcare utilization in patients with FM taking antidepressant medication for their comorbid depression.

Methods Patients from 38 centers in the United States, Europe (Italy, Spain), and Canada were enrolled in a phase 3 study of pregabalin efficacy and safety (NCT01432236). Patients with FM aged ≥18 years were taking a stable dose of a single selective serotonin reuptake inhibitor or serotonin/norepinephrine reuptake inhibitor for their comorbid depression for ≥2 months prior to randomization. FM-related work productivity and healthcare utilization were assessed at randomization. Work productivity over the preceding 7 days was measured using the Work Productivity and Activity Impairment:Fibromyalgia Symptoms (WPAI:FMS) questionnaire, a self-reported measure of FM-related absenteeism (work time missed), presenteeism (impairment while working), overall work impairment (absenteeism plus presenteeism), and activity impairment (impairment of regular activities other than work). Absenteeism, presenteeism, and overall work impairment were measured for employed individuals only. Each score is expressed as a percentage, higher scores indicating less productivity and greater impairment. Healthcare utilization related to FM in the preceding 3 months was measured using a self-reported Healthcare Utilization Assessment questionnaire that captured: number of healthcare professional (HCP) visits, hospitalizations, and emergency room (ER) visits; use of physical treatments and supplements; time other people spent providing help with activities of daily living without receiving payment; and out of pocket expenses for physical treatments, supplements, prescription and non-prescription medications, and professional services to assist with activities of daily living.

Results 193 patients were evaluated at randomization. FM-related work productivity scores (mean ± SD) in the preceding 7 days were: absenteeism 15.2 ± 25.4% (n = 86), presenteeism 54.0 ± 21.5% (n = 83), overall work impairment 58.0 ± 23.4% (n = 82), and activity impairment 65.0 ± 18.8% (n = 193). In the preceding 3 months, the total number (mean ± SD) of HCP visits related to FM was 5.0 ± 6.6. There were no hospitalizations but 12 (6.2%) patients visited the ER. 67 (34.7%) and 61 (31.6%) patients used physical treatments and supplements, respectively. The number of hours (mean ± SD) other people spent providing help without payment was 50.4 ± 98.1. In patients who incurred out of pocket expenses in the preceding 3 months, total (mean [range]) expenditure was $US 307.12 (0–5,300; n = 110), EUR 410.43 (0–2,485; n = 49), and $CAN 211.26 (0–1,000; n = 19).

Conclusion FM affects work productivity and regular activities other than work in patients with FM taking antidepressant medication for their comorbid depression. In these patients, FM is associated with substantial healthcare utilization, and generates considerable out of pocket expenses.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/work-productivity-and-healthcare-utilization-in-patients-with-fibromyalgia-and-comorbid-depression-taking-antidepressant-medication/