Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Perspectives on Fibromyalgia From Trainees At An Academic Health Center.
Lobert1, Jennifer, Morgan1, Xolti, Arnold2, Lesley M.
Fibromyalgia (FM) is a common disorder in the US with an estimated 2% prevalence in the adult population. There are no published studies on trainees' attitudes towards FM and the degree of confidence in diagnosing and managing the disorder. We hypothesized that despite recent advances in the understanding of the pathophysiology and treatment of FM, there is still uncertainty among some trainees about the legitimacy of FM as a medical disorder. We propose that this uncertainty is due to inadequate quality and quantity of education.
We conducted a survey of residents and fellows in all departments of a large academic medical center using an anonymous, secure, web-based survey that consisted of questions related to education about diagnosis and treatment of FM, experience with FM, and personal beliefs about FM. To determine which factors were significantly associated with considering FM to be a legitimate medical disorder we used the Chi-Square test and univariate odds ratios. Those variables that were significant at a p value <0.10 were included in a multivariate logistic regression model predicting which residents thought FM was a legitimate medical disorder.
The survey was completed by 154 of 642 residents and fellows. Respondents were more likely than the overall group to be Caucasian, in the first 3 years of training, and in primary care. Only 36% believed that FM was a legitimate medical disorder. Respondents who believed that FM was a legitimate medical disorder were more likely to be confident in treating FM (OR 3.16, 1.46.9) and to believe that FM patients were not more difficult to manage than other patients (OR 2.5, 1.06.0). Those who were confident in treating FM were more likely to be in primary care and to have diagnosed and treated FM. They also reported satisfactory or better quantity and quality of education on diagnosis and treatment of FM. They understood the pathophysiology of FM and were comfortable discussing FM with patients and attendings.
Despite advances in the understanding of the pathophysiology and management of FM, a minority of residents and fellows at a large academic medical center believe that FM is a legitimate medical disorder. Those who believe in its legitimacy are more confident in diagnosing and treating the disease. Factors that contribute to increased confidence include regular exposure to patients with FM and adequate quantity and quality of the educational experience. Interventions aimed at increasing trainees' clinical experience with FM patients and improving the quantity and quality of FM education may enhance trainees' level of confidence in diagnosing and treating FM as a legitimate medical disorder. This, in turn, will increase the percentage of trainees who believe in the legitimacy of the disorder and lead to improved FM patient care.
To cite this abstract, please use the following information:
Lobert, Jennifer, Morgan, Xolti, Arnold, Lesley M.; Perspectives on Fibromyalgia From Trainees At An Academic Health Center. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1913