Diagnosing & Caring for Patients with Fibromyalgia

Model of Care

Dr. Schiopu says this dissatisfaction with the healthcare system is probably warranted because the medical community still does not fully understand the pathophysiology behind the heterogeneous presentation of fibromyalgia and may demonstrate “medical animosity” to the patient. Although it’s not obvious these patients should be treated by rheumatologists, as opposed to pain specialists, patients with multi-system complaints, such as those seen in patients with fibromyalgia, are frequently referred to a rheumatologist, and thus, diagnosis and treatment of fibromyalgia are problems for rheumatologists.

Absent a good therapeutic option, Dr. Schiopu focuses on improving the patient’s quality of life, Patients may benefit from treatment from a psychologist and/or psychiatrist, she says.

This study delivers an important message, says Dr. Schiopu: Physicians need to be better at recognizing fibromyalgia and have access to a model of care for evidence-based approaches to manage fibromyalgia that will improve patient outcomes—particularly approaches for patients who wish to remain employed.

Dr. Schiopu also believes the diagnosis of fibromyalgia should be emphasized in the medical school curriculum. Until that happens, she says, “These patients end up bouncing back and forth.”

References

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4. Wolfe F, Walitt B, Perrot S, et al. Fibromyalgia diagnosis and biases assessment: Sex, prevalence, and bias. PLoS One. 2018Sep 13;13(9):e0203755.
5. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014 Apr 16;311(15):1547–1555.