Fibromyalgia patients can develop additional health conditions similar to other patients with diseases, but they receive more and prolonged medication treatments to treat these conditions, according to new research.
The study, “Fibromyalgia Is Associated To Receiving Chronic Medications Beyond Appropriateness: A Cross-Sectional Study,” was published in the journal Rheumatology International.
Previous studies have shown that fibromyalgia is one of the rheumatic diseases that is more often associated with a greater number of other health conditions, and has a considerable impact on the patient’s quality of life.
“Managing this situation effectively requires a multidisciplinary approach for treating all the problems together rather than separately,” the authors wrote in their report. “However, it is unknown whether [fibromyalgia] diagnosis determines the treatment of these symptoms.”
The study’s aim was to evaluate the medications prescribed for the treatment of all the health conditions present in fibromyalgia patients and assess the appropriateness of the treatments.
The study enrolled 159 patients at the Rheumatology Clinic in the Comunidad Autónoma of Madrid, Spain. All patients were women from 18 to 65 years old. They were classified into three groups: group 1 (previous fibromyalgia diagnosis and fulfilling ACR criteria, 59 patients); group 2 (no fibromyalgia diagnosis and not fulfilling ACR criteria, 67 patients); and group 3 (no fibromyalgia diagnosis but fulfilling ACR criteria, 33 patients).
The ACR is the American College of Rheumatology.
Prescription medication used by the patients included those for the nervous system (benzodiazepines and antidepressants); analgesics and anti-inflammatories; and medication and supplements for treating other conditions.
The appropriateness of each medication was analyzed according to clinical therapeutical guidelines used in Spain, and health conditions were classified as severe or mild following the researchers’ criteria. Severe conditions included high blood pressure, osteoporosis, and diabetes mellitus. Mild conditions included lactose intolerance and reduced levels of vitamin D, iron, folic acid, or Q10.
The analysis showed that, compared to the other groups, group 1 received a higher number of medications and for a longer period. These patients were commonly prescribed drugs for conditions related to the nervous system, migraines, dizziness, gastric protectors, and analgesics, although these clinical conditions were also found in patients without fibromyalgia.
Patients in group 1 took medications to treat severe conditions, but in a similar way as other patients, showing that fibromyalgia does not increase the incidence of the manifestations. However, these group 1 patients took drugs for mild conditions significantly more often than other patients. Because these milder conditions are often not based on clinical recommendations, the authors find this approach poorly justified.
“The appropriateness of the severe comorbidity treatments has shown that criteria for treatment were well established following clinical practice guidelines,” the team wrote. “However, for mild comorbidities, patients with [fibromyalgia] received a greater number of treatments which were not well justified. This means that some drugs used for treating some clinical symptoms should be eliminated.”
In addition, more patients from group 1 (45.8 percent) were in psychiatric care compared to the other groups (15.6 percent in group 3, and 3 percent in group 2), but researchers do not know whether psychiatric symptoms appear before or after the onset of fibromyalgia.
The number of physical symptoms also correlated significantly with the number of medications — that is, the more symptoms the patients experienced, the more medications they would take.
“The types of comorbidities found in patients with [fibromyalgia] were similar to the ones in the control patients without fibromyalgia,” the authors concluded. “The most relevant differences were the higher number and the longer duration of the treatments found in patients with [fibromyalgia] in this study.”
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