Estudo comparativo das características clínicas e abordagem de pacientes com fibromialgia atendidos em serviço público de reumatologia e em consultório particular

Abstract

Introduction: Fibromyalgia is a painful chronic syndrome associated to tender areas on digital palpation. Its origin is unknown and probably related to a dysfunction on pain processing pathways. The most frequent accompanying symptoms are: fatigue, sleeping disorders, chronic migraine, irritable bowels syndrome and others disorders. There is an important emotional influence related to stress response. Education, social and economical status could influence clinical presentation. The main purpose of the present study are to determine if there are differences in clinical presentation, symptoms intensity and type of treatment among patients treated in public or private health systems and establish if there is a correlation among main symptoms intensity, family income and formal education status. Patients and Methods: Eighty patients that fulfilled the American College of Rheumatology (ACR) Classification Criteria for Fibromyalgia had been studied. They were divided in two groups according to treatment location: 40 patients have been assisted at the Rheumatology Outpatient Clinic of Sorocaba Hospital Complex (SHC) and 40 patients at one of the authors' private practice. Clinical variables (pain, fatigue, anxiety, depression and quality of life) were measured through a numerical analogic scales (0-10). Family income was evaluated according to the number of minimum wages earned monthly and education according to complete years of formal education. Comparison among groups was analyzed using Chi-square, ANOVA tests and difference among average values. Results: Studied groups were similar regarding to pain, fatigue, anxiety and depression intensity, and number of painful spots, regular practice of physical exercises and disease duration. There have been differences related to age (younger people in private system) and regarding to familiar income and education (higher in private system). Correlation among symptoms intensity and family income or education showed no statistical differences. Conclusion: There has been no observed relation among fibromyalgia clinical presentation and social or economical status. It was observed association between private assistance service access and lower age of disease installation.