The Burden of Fibromyalgia: Assessment of Health Status Using the EuroQol (EQ-5D) in Patients with Fibromyalgia Relative to Other Chronic Conditions

Abstract 

Objective

To compare the health status of fibromyalgia patients assessed by EuroQol (EQ-5D) with healthy controls and patients with chronic conditions, and to identify modifiable clinical factors associated with the EQ-5D.

Study Design

EQ-5D scores were calculated using US preference weights for patients with fibromyalgia from a published patient survey. Scores were compared with healthy controls and individuals with chronic conditions (cancer, diabetes, asthma, headache, hypertension, myocardial infarction, coronary atherosclerosis, congestive heart failure, osteoarthritis, rheumatoid arthritis, and spondylopathies) from the Medical Expenditure Panel Survey. Demographic and clinical factors associated with the EQ-5D were identified using regression analyses.

Results

Adjusted for age and sex, the mean (±SD) EQ-5D score was 0.56±0.18 among fibromyalgia patients; significantly lower, that is, worse (P <.0001), than that of healthy controls (0.89±0.46) and other chronic conditions (P <.0001). Differences in scores between fibromyalgia patients and comparators were ≥.074, indicating clinical significance. Patient self-reported fibromyalgia symptom severity was a significant factor associated with the EQ-5D. Compared with “very severe” patients, those with “moderate,” “mild,” and “very mild” symptoms had significantly (P <.05) higher mean EQ-5D scores. Major depressive disorder also was a significant factor, but anxiety, cognitive dysfunction, and chronic fatigue syndrome were not; neither were fibromyalgia duration and number of tender points.

Conclusions

EQ-5D scores in fibromyalgia patients were significantly lower than healthy controls and individuals with other chronic conditions. Self-reported symptom severity was significantly associated with the EQ-5D. A substantial health burden for fibromyalgia has been highlighted and results suggest that effective symptom management is necessary to improve the health status of fibromyalgia patients.

Keywords: EQ-5D, Fibromyalgia, Health burden, Health status