title: Burden of illness and treatment patterns for patients with fibromyalgia.
abstract: OBJECTIVE
  This study was designed to describe burden of illness and treatment patterns, and to examine the patient, physician, and care factors associated with the treatment choices of individuals receiving new prescriptions for fibromyalgia (FM).
  
  
  METHODS
  This is a baseline assessment of the Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments (REFLECTIONS), a prospective observational study. Baseline data (including a physician survey, a patient visit form, and computer-assisted telephone interviews) were collected from July 2008 through May 2010 in 58 care settings in the United States, including Puerto Rico.
  
  
  RESULTS
  Patients (N = 1,700) were mostly female (94.6%) and white (82.9%). Mean age was 50.4 years and mean duration of illness was 5.6 years. Mean Fibromyalgia Impact Questionnaire total score was 54.4 (range 0-80), and Brief Pain Inventory average pain severity level was 5.5 (range 0-10). Patients reported high annual health care use and numerous work limitations related to FM. Patients were taking 182 unique types of medications prescribed for FM, including duloxetine (26.8%), nonsteroidal anti-inflammatory drugs (26.6%), pregabalin (24.5%), opioids (24.2%), tramadol (15.3%), benzodiazepines (15.2%), cyclobenzaprine (12.9%), milnacipran (8.9%), and others. Most patients took more than one medication concurrently (77.8%). Type of current medications used was most strongly associated with medication history and physician specialty.
  
  
  CONCLUSIONS
  Burden of illness was high for patients with FM, and treatment patterns were highly variable. Importantly, the treatments with the most evidence to support their use were not always the most frequently chosen.
authors.affiliation: Eli Lilly and Company, Indianapolis, IN 46285, USA. rlrobinson@lilly.com
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Robinson
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
authors.forename: Philip
authors.initials: P
authors.lastname: Mease
authors.forename: David A
authors.initials: DA
authors.lastname: Williams
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Deborah
authors.initials: D
authors.lastname: D'Souza
authors.forename: Madelaine
authors.initials: M
authors.lastname: Wohlreich
authors.forename: Bill
authors.initials: B
authors.lastname: McCarberg
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D017281:Cost of Illness; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'
chemical_list: D000700:Analgesics