A PROSPECTIVE, LONGITUDINAL, MULTICENTER STUDY OF SERVICE UTILIZATIONAND COSTS IN FIBROMYALGIA

Objective. To study, for the first time, service utilization and costs in fibromyalgia, a prevalent syndrome associated with high levels of pain, functional disability and emotional distress, Methods. Five hund red thirty-eight fibromyalgia patients from 6 rheumatology centers wer e enrolled in a 7-year prospective study of fibromyalgia outcome, Pati ents were assessed every 6 months with validated, mailed questionnaire s which included questions regarding fibromyalgia symptoms and severit y, utilization of services, and work disability, Results, Fibromyalgia patients averaged almost 10 outpatient medical visits per year, and w hen nontraditional treatments were considered, this number increased t o similar to 1 visit per month, Patients were hospitalized at a rate o f 1 hospitalization every 3 years, In each 6-month study period, patie nts used a mean of 2.7 fibromyalgia-related drugs. Costs increased ove r the course of the study, The mean yearly per-patient cost in 1996 do llars was $2,274. However, results were skewed by high utilizers, and many patients used few services and had limited costs, Total costs and utilization were independently associated with the number of self-rep orted comorbid or associated conditions, functional disability, and gl obal disease severity, Compared with patients with other rheumatic dis orders, those with fibromyalgia were more likely to have lifetime surg ical interventions, including hack or neck surgery, appendectomy, carp al tunnel surgery, gynecologic surgery, abdominal surgery, and tonsill ectomy, and were more likely than other rheumatic disease patients to report comorbid or associated conditions, Almost 50% of hospitalizatio ns occurring during the study were related to fibromyaigia-associated symptoms. Conclusion, The average yearly cost for service utilization among fibromyalgia patients is $2,274, Fibromyalgia patients have high lifetime and current rates of utilization of all types of medical ser vices, They report more symptoms and comorbid or associated conditions than patients with other rheumatic conditions, and symptom reporting is linked to service utilization and, to a lesser extent, functional d isability and global disease severity.