title: Longitudinal observation of treatment patterns and outcomes for patients with fibromyalgia: 12-month findings from the reflections study.
abstract: OBJECTIVE
  To describe 12-month treatment patterns and outcomes for patients starting a new medication for fibromyalgia in routine clinical practice.
  
  
  METHODS
  Data from 1,700 patients were collected at baseline and 1, 3, 6, and 12 months. Repeated measures and Poisson regression models controlling for demographic, clinical, and baseline outcomes were used to assess changes in health outcomes (Brief Pain Inventory severity and interference, Sheehan Disability Scale, Fibromyalgia Impact Questionnaire), satisfaction, and economic factors for patients who initiated on pregabalin (214, 12.6%), duloxetine (264, 15.5%), milnacipran (134, 7.9%), or tricyclic antidepressants (66, 3.9%). Sensitivity analyses were run using propensity-matched cohorts.
  
  
  RESULTS
  Patients started on 145 unique drugs for fibromyalgia, and over 75% of patients took two or more medications concurrently for fibromyalgia at each time point assessed. Overall, patients showed improvement on the four health outcomes, with few differences across medication cohorts. At baseline, patients reported annual averages of 20.3 visits for outpatient care, 27.7 missed days of work, and 32.6 days of care by an unpaid caregiver. The duloxetine and milnacipran (vs pregabalin or tricyclic antidepressant) cohorts had fewer outpatient visits during the 12-month study. Patients reported satisfaction with overall treatment and their fibromyalgia medication (46.0% and 42.8%, respectively).
  
  
  CONCLUSIONS
  In this real-world setting, patients with fibromyalgia reported modest improvements, high resource, and medication use, and were satisfied with the care they received. Cohort differences were difficult to discern because of the high rates of drug discontinuation and concomitant medication use over the 12-month study period.
authors.affiliation: Eli Lilly and Company, Indianapolis, Indiana.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Robinson
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
authors.forename: David A
authors.initials: DA
authors.lastname: Williams
authors.forename: Philip
authors.initials: P
authors.lastname: Mease
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Douglas
authors.initials: D
authors.lastname: Faries
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Peng
authors.forename: Danette
authors.initials: D
authors.lastname: Hann
authors.forename: Madelaine
authors.initials: M
authors.lastname: Wohlreich
authors.forename: Bill
authors.initials: B
authors.lastname: McCarberg
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000700:Analgesics
keywords: Fibromyalgia; Longitudinal; Observational; Outcomes; Pharmacotherapy; Treatment