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Rheumatologists and PCPs have similar perceptions regarding the pathophysiology of FMS

Comparing Practice Patterns in Fibromyalgia Syndrome (FMS) Rheumatology versus Primary Care Practice Terence W. Starz, Molly T. Vogt, Jennifer Keeler University of Pittsburgh Medical Center, Pittsburgh, PA; Pennsylvania Rheumatology Society, Harrisburg, PA. Introduction. Results.

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Rheumatologists and PCPs have similar perceptions regarding the pathophysiology of FMS

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  1. Comparing Practice Patterns in Fibromyalgia Syndrome (FMS) Rheumatology versus Primary Care PracticeTerence W. Starz, Molly T. Vogt, Jennifer KeelerUniversity of Pittsburgh Medical Center, Pittsburgh, PA; Pennsylvania Rheumatology Society, Harrisburg, PA Introduction Results Beliefs regarding pathology of FMS It is estimated that 5 million people in the US currently haveFMS. This is more than the combined total of patients with RA (1.3 M), SLE (322,000), scleroderma (49,000), PMR (228,000), and gout (3.0 M). The purpose of this study is to compare and contrast the impact of FMS patients on the practice activities of rheumatologists and primary care practitioners (PCPs). Management of FMS patients (expressed as %) RheumPCPsp value Diagnosis Use ACR criteria 75 56 <0.05 ESR 86 86 - Thyroid function 94 91 - Metabolic profile 78 82 - Vitamin D level 49 17 <0.05 RF 58 76 <0.05 Anti-CCP 32 6 <0.05 ANA 61 76 <0.05 HLA-B27 7 2 - Management Any intervention 95 95 - Exercise 97 93 - Physical therapy 87 91 - Cognitive therapy 52 29 <0.05 Medications NSAIDs 57 84 <0.05 Cyclobezaprine 87 56 <0.05 SNRIs 87 79 - SSRIs 57 76 <0.05 Alpha-2 delta ligs 87 66 <0.05 Require more time 90 87 - Make up more than 61 3 <0.05 10% of practice Methods A questionnaire was sent via email or fax to 199 rheumatologists throughout Pennsylvania and 183 PCPs in southwestern Pennsylvania. Response rate: 37% rheumatologists and 48% PCPs Information was obtained on the perceptions of rheumatologists and PCPs  about the diagnosis and management of FMS:     - was it a medical or psychological condition    - were the 1990 ACR criteria used in diagnosis    - were laboratory and imaging studies ordered - treatments used - the impact of FMS patients on clinical practice     - proportion of patients with FMS    - office time spent with FMS patients. Analysis was performed using descriptive statistics and chi-square test for comparisons. Conclusions • Rheumatologists and PCPs have similar • perceptions regarding the pathophysiology of FMS • and agree that FMS patients require more office • time than other patients. • But • the methods used to confirm the diagnosis differ. • the clinical management style also differs with rheumatologists prescribing NSAIDs less frequently and alpha-2-delta ligand inhibitors more frequently than PCPs.

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