AB0148 DIAGNOSTIC DELAY ON FIBROMYALGIA DIAGNOSIS AND ITS IMPACT ON THE SEVERITY AND OUTCOME
Authors: F. Salaffi, S. Farah, B. Bianchi, M. G. Lommano, M. DI Carlo
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Fibromyalgia (FM) is a chronic pain syndrome which has a great impact on general health and functional capacity of affected subjects. As it is seen in other painful disorders, we hypothesized that an early approach would diminish the negative impacts FM has on patient's lives. We could imagine that patients with a greater time between the initiation of symptoms until the diagnosis and the beginning of adequate treatment would have the worst outcomes. An unknown, yet important question is whether early diagnosis and early treatment can influence long term outcomes in FM patients. <h3>Objectives:</h3> The objectives of this study were to evaluate the diagnostic delay (DD) on FM diagnosis and its impact on the severity and outcome. <h3>Methods:</h3> The data of this study were retrospectively extracted from a large database of patients with FM belonging to the Italian Fibromyalgia Registry (IFR), residents of the Marche Region [1]. Six hundred and sixteen patients affected by FM were enrolled in a third-level rheumatology center that represents the regional referral for the diagnosis and treatment of FM. The diagnosis of FM was formulated according to the 2016 ACR criteria. The following information was obtained: DD, revised Fibromyalgia Impact (FIQR), modified self-administered Fibromyalgia Assessment Status (FAS mod) [2], polysymptomatic distress scale (PDS) scale (SSS + WPI), Patient-Reported Outcomes Thermometer-5-Item Scale (5T-PROs) [3] and widespread pain index (WPI). <h3>Results:</h3> The patients' average age was 52.3 (9.3) years, and 84% were female. The FIQR, PDS, FAS mod, 5T-PROs and WPI were 46.7 (21.7), 16.4 (8.9), 23.0 (9.2), 27.9 (15.6) and 10.3 (4.9), respectively. The mean (SD) total time to diagnosis among all FM was 3.5 (2.4) years. We identified three groups of patients: early diagnosis (ED: 0-1 years; 169 patients), late diagnosis (LD: &gt; 2-5 years; 320 patients), and very late diagnosis (VLD: &gt; 5 years; 127 patients). When the three groups were examined, the mean FIQR in the ED, LD, and VLD groups was 36.6 (21.8), 46.4 (20.8), and 58.4 (18.9), respectively (p &lt; 0.001), the mean FAS mod was 19.8 (9.4), 22.5 (8.7), and 28.5 (8.0), respectively (p = 0.004), whereas the mean total PDS scale was 13.7 (8.0), 16.1 (9.1), and 21.0 (7.6), respectively (p &lt; 0.001). Further, the mean 5T-PROs in the ED, LD, and VLD groups was 24.1 (14.8), 27.1 (14.8), and 35.2 (16.1), respectively (p &lt; 0.0001), whereas the mean WPI was 8.6 (4.9), 9.9 (4.5), and 13.3 (4.7), respectively (p &lt; 0.001) <h3>Conclusion:</h3> Delayed diagnosis of FM is associated with poorer patient outcomes; including worsening severity index and PRO scores. FS diagnosis periods could likely be attenuated by increasing disease awareness amongst physicians; thus, improving patient measures (PROMs) of severity of the disease in patients with FM. <h3>REFERENCES:</h3> [1] Salaffi F, Farah S, Di Carlo M, Sinigaglia L, Galeazzi M, Gerli R, Sonnati M, Giorgi V, Sarzi-Puttini P, Masullo M; Italian Society of Rheumatology (SIR) and Ministero della Salute - Direzione Generale della Programmazione Sanitaria, Roma, Italy.. The Italian Fibromyalgia Registry: a new way of using routine real-world data concerning patient-reported disease status in healthcare research and clinical practice. Clin Exp Rheumatol. 2020;38 Suppl 123(1):65-71. [2] Salaffi F, Di Carlo M, Farah S, Atzeni F, Buskila D, Ablin JN, et al. Diagnosis of fibromyalgia: comparison of the 2011/2016 ACR and AAPT criteria and validation of the modified Fibromyalgia Assessment Status. Rheumatology (Oxford) 2020;59:3042-9. [3] Salaffi F, Di Carlo M, Carotti M, Farah S. The Patient-Reported Outcomes Thermometer-5-Item Scale (5T-PROs): Validation of a New Tool for the Quick Assessment of Overall Health Status in Painful Rheumatic Diseases. Pain Res Manag. 2018 Oct 23;2018:3496846. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>