Clinical characteristics of fibromyalgia patients attending an Australian public hospital clinic.

Abstract

Aim: To describe the clinical characteristics of Australian fibromyalgia patients attending a public clinic. Method(s): First visit data was collected from consecutive patients attending the Monash Fibromyalgia Clinic from March 2008 until August 2019. Demographic, clinical and self-report illness impact information was recorded and comparisons made between groups based on demographic, clinical and treatment features. Result(s): 881 patients were included. Mean age 45.5 +/- 13.32 years, 90.7% female, 86% Caucasian and 39.8% on government pension. 87.9% reported an illness trigger, mostly psychological stressors. Many reported diagnosed depression (67.9%) or anxiety (68%). Mean symptom duration was 11.37 +/- 9.77 years, mean Fibromyalgia Impact Questionnaire score 67.67 +/- 15.34, Widespread Pain Index (WPI) 12.27 +/- 3.99, Symptom Severity Score (SSS) 8.87 +/- 2.02 and Central Sensitivity Score 21.06 +/- 5.11. At presentation, 36.8% were using fibromyalgia-specific medication, 46.1% exercised regularly, 12.6% currently used pain management psychology and 46.7% were using complementary/alternative therapies. Patients reporting a psychological trigger had worse overall illness impact, poorer sleep, fatigue, depression and anxiety(P <= 0.005) and worse pain(P = 0.04) and those reporting depression or anxiety diagnoses had higher illness impact throughout(P <= 0.001). Non-Caucasian patients had higher depression and anxiety scores(P <= 0.05) and those receiving government pensions recorded worse scoring in all outcomes(P <= 0.005) except the WPI. If using fibromyalgia medication, overall illness impact and pain was less(P <= 0.05). If exercising then illness impact, pain, sleep disturbance, fatigue, anxiety and depression(P <= 0.005) were significantly less. The small group using pain management psychology had improved SSS(P = 0.03) but no other significant difference, however those using complementary/alternative therapies had less illness impact, less pain, fatigue(P <= 0.005) and sleep disturbance(P = 0.04). Conclusion(s): A high psychological burden existed in many patients presenting to a public hospital outpatient fibromyalgia clinic, and these patients reported worse illness impact. Patients actively engaged in management strategies involving exercise, complementary/alternative therapies or fibromyalgia-specific medication had less self-reported illness impact than those who were not.