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Chiropractic Research Review

Fibromyalgia: Costs and Service Utilization

Fibromyalgia is commonly characterized by muscular pain lasting three months or more, tenderness in specific muscle points, and various associated symptoms, including fatigue, headache, numbness and tingling sensations.

Although an estimated five million people suffer from fibromyalgia, little is known about the costs and utilization of services associated with this frustrating condition.

In a well-designed, rigorous seven-year study involving 538 fibromyalgia patients at five clinics across the United States, mailed questionnaires assessed severity of symptoms, utilization of health care services and work disability at six-month intervals. Analysis of the data revealed the following:

* Chiropractors were one of the more common health care professionals visited by patients, averaging 30.4 visits per 100 patients (per six-month period).

* However, the most frequently consulted health providers for fibromy-algia patients were physical and occupational therapists (129 visits per 100 patients in six months) followed by rheumatologists (100.4 patients).

* Fibromyalgia patients averaged about 10 outpatient medical visits per year, and this number increased to nearly one visit per month when nontraditional treatments (massage, acupuncture, acupressure, and homeopathic and herbal remedies) were considered.

* Patients used an average of 2.7 fibromyalgia-related drugs per six-month study period.

* Costs increased over the course of the study, reaching a high average of $2,274 annually per patient.

Conclusions: Fibromyalgia patients have high lifetime and yearly rates of utilization and report more symptoms and
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comorbid or associated conditions than patients suffering from other rheumatic conditions. These findings emphasize the potential for chiropractors to enjoy higher levels of service utilization by this population of patients.

Wolfe F, Anderson J, Harkness D, et al. Prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia. Arthritis and Rheumatism, 1997:40, pp1560-70.

Chiropractic Research Review

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