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Is There Benefit in Referring Patients with Fibromyalgia to a Specialist Clinic?
FRANCIS SI WAI ZIH, DEBORAH DA COSTA, and MARY-ANN FITZCHARLES
ABSTRACT. Methods. A retrospective chart review was performed for the first 238 patients attending a rheumatology subspecialty FM clinic. The main variables of interest were management received at the clinic, final diagnosis, and outcome. Results. The final diagnosis was FM in 68%, and some other condition in the remaining 32%. Specialist contact was identified as useful in 73% of the total patient group, 96 with FM and 74 with non-FM. In the patients with FM who received followup in the clinic, outcome was judged favorable in 54%, whereas 46% showed no change or decline in health status. Conclusion. An important value of specialist rheumatology contact for patients with a symptom suggestive of diffuse musculoskeletal pain is to ensure that some other potentially treatable condition is not overlooked, rather than the provision of ongoing care for those with FM. Continued followup in a specialist clinic for patients with a primary diagnosis of FM is of questionable benefit. (J Rheumatol 2004;31:2468-71) Key Indexing Terms:
FIBROMYALGIA
From the Division of Rheumatology and McGill Pain Centre, Department of Medicine, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada. F.S.W. Zih, BSc, Research Associate, Division of Rheumatology; D. Da Costa, PhD, Assistant Professor, Department of Medicine; M. Fitzcharles, MB, ChB, Associate Professor of Medicine, Division of Rheumatology and McGill Pain Centre. Address reprint requests to Dr. M. Fitzcharles, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Ave, Montreal, Quebec, H3G 1A4. E-mail: mary-ann.fitzcharles@muhc.mcgill.ca Submitted March 22, 2004; revision accepted June 30, 2004. |