Is there benefit in referring patients with fibromyalgia to a specialist clinic?
OBJECTIVE
To examine the benefit of specialist rheumatology consultation and followup for the first 238 patients referred to a tertiary care fibromyalgia (FM) clinic with emphasis on final diagnosis and outcome.


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.


CONCLUSIONS
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.
Zih
Francis Si Wai
FS
Division of Rheumatology and McGill Pain Centre, Department of Medicine, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada.
Da Costa
Deborah
D
Fitzcharles
Mary-Ann
MA
D000328:Adult; D000554:Ambulatory Care Facilities; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis* / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010147:Pain Measurement; D011336:Probability; D011792:Quebec; D012016:Reference Values; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012219:Rheumatology / Q000592:standards*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome