title: Comparing fibromyalgia patients from primary care and rheumatology settings: clinical and psychosocial features.
abstract: The aim of this study was to compare clinical symptoms, perceived health status, health resource use and psychosocial features in fibromyalgia (FM) patients at different health care levels. A total of 315 participants were recruited from primary care (PC) (n=101) and rheumatology settings (RS) (n=214). Subjects completed a protocol of clinical features and health resource use, hospital anxiety and depression scale, sickness impact profile, chronic pain self-efficacy scale, multidimensional pain locus of control scale, perceived health competence scale and chronic pain coping inventory. Student's t test, effect size, and contrast and power test were performed to examine differences between samples. FM patients treated in PC and RS were similar in most variables assessed and only differed significantly in tender points, sleep disturbance, wellness-focused coping strategies and in self-efficacy beliefs. The similarities do not support patient selection through care levels and thus, in the Spanish health care system at least, endorse PC as a reference unit for treatment and questioning the benefits of referring patients to RS.
authors.affiliation: Departamento de Psicología de la Salud, Universidad Miguel Hernández, Campus de San Juan, Crta. N-332, 03550, San Juan de Alicante, Spain. ana.lledo@umh.es
authors.forename: Ana Lledó
authors.initials: AL
authors.lastname: Boyer
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Mira Pastor
authors.forename: Nieves Pons
authors.initials: NP
authors.lastname: Calatayud
authors.forename: Sofía
authors.initials: S
authors.lastname: Lopez-Roig
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Cantero Terol
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D005356:Fibromyalgia / Q000523:psychology* / Q000628:therapy*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D011320:Primary Health Care; D012219:Rheumatology; D018434:Sickness Impact Profile