P180 Impact of fibromyalgia on work: informing strategies for enablement
Authors: Hollick Rosemary J , Doebl Stefanie , Skea Zoe , Macfarlane Gary , Locock Louise , Walker-Bone Karen ,   PACFiND study investigators
Published: April 2022

Abstract

Background/Aims
The Getting It Right First Time Report for Rheumatology recommends that care for patients with non-inflammatory painful MSK conditions such as fibromyalgia should be provided in primary and community care settings, and include reablement support. Employment that is safe, healthy, and gives individuals some control is good for physical and mental health and is of prime importance to patients with most MSK conditions. However, limited evidence exists about the impact of fibromyalgia on work ability and how to support this. We aimed to understand impacts of fibromyalgia on work ability in order to inform strategies for reablement.

Methods
Narrative qualitative interviews were undertaken with people with fibromyalgia across the UK. We explored views about care and treatment, and the impact fibromyalgia had on their wider lives, including work. Interviews were analysed thematically using an interpretive approach. Data management and initial analytic coding was supported by N*VIVO software.

Results
31 people were interviewed; 26 female and 5 male. Participants were aged between 23 and 77 years (median 53 years). Time since diagnosis ranged from &lt;1 year to &gt; 20 years. Many people with fibromyalgia wanted to work and described its value. However, some described having to give up work or retire early because of their fibromyalgia. Those who remained in work reported often struggling mentally and physically with the demands of their job, mentioning: poor memory; brain fog; poor concentration; poor sleep and fatigue, along with side effects of pain medication. Committing to work was reportedly difficult due to the unpredictable nature of fibromyalgia causing concern about letting people down. Fibromyalgia was often described as an invisible illness, with colleagues and employers having little knowledge about fibromyalgia. Several people said that their employers were supportive; flexibility in how, when and where work tasks were done were highly valued e.g. flexible hours, additional rest breaks and home-working. Others felt they were perceived as a burden or ‘malingerer.’ Those without a formal diagnosis particularly struggled to access support. People often reported struggling to remain working for as long as possible before being unable to continue. Some actively made career choices that provided flexibility to remain at work e.g., changing career, becoming self-employed. Younger participants described disruption to school and university courses. Some reported completely re-thinking their intended career and described grief for the life and career to which they had aspired. There was a perceived lack of advice and support about working with fibromyalgia.

Conclusion
Work is an important part of rehabilitation and enablement for people with fibromyalgia. Services for fibromyalgia should facilitate early diagnosis and support for those who want to work, particularly for younger people as well as older adults who may find it harder to remain in the workplace.

Disclosure
R.J. Hollick: None. S. Doebl: None. Z. Skea: None. G. Macfarlane: None. L. Locock: None. K. Walker-Bone: None.