CORRELAÇÃO DOS NÍVEIS DE SATISFAÇÃO OBTIDOS ATRAVÉS DO PASS (PATIENT ACCEPTABLE SYMPTOM STATE) COM OS ESCORES DO FIQ REVISADO (THE REVISED FIBROMYALGIA IMPACT QUESTIONNAIRE) EM PACIENTES COM FIBROMIALGIA

Abstract

In recent years, Patient Related Outcomes (PROs) have received more importance by providing meaningful informations answered by the patients about their symptoms, functional status, quality of life and satisfaction, and also for giving relevant information about treatment efficacy. The main objective of this study was to evaluate the satisfaction of fibromyalgia patients through PASS and determine the correlation of scores obtained with FIQR in relation to PASS. Other objectives were:to determine the value of best accuracy of FIQR in relation to PASS; to compare the FIQR scores between satisfied and dissatisfied patients and FIQR scores between patients with disability claims or on work disability, in relation to the rest of the sample; to compare the mean scores from HAQ, Beck and PSD questionnaires between satisfied and not satisfied patients and evaluate the correlation between the questionnaires. In the studied sample, 82 fibromyalgia patients were assessed, from public and private healthcare services, according to the modified ACR 2010 criteria. Sociodemographic and clinical data were collected and the impact of fibromyalgia was assessed by FIQR, the satisfaction by PASS and Likert scale, functional capacity by HAQ, depression by the Beck Depression Inventory and the polysymptomatic distress by PSD. In this sample depression (87%) and rheumatological diseases (64%) were the main comorbidities. Most patientes made use of antidepressants (96%) and analgesics (81%), but only 21% of patients performed at least 150 minutes of aerobic exercise per week. The results from the questionnaires showed severe impact of fibromyalgia, severe polysymptomatic distress, moderate to severe functional disability and moderate to severe depression symptoms. Patients with disability claims, or on work disability showed statistical difference in FIQR and Beck mean scores when compared to the rest of the sample. Patient satisfaction was considerably low in PASS (15% satisfied), as well as in Likert scale: 2.3 ± 2.8. There was no statistical difference between sociodemographic and clinical variables in relation to PASS satisfaction, except in older patients (p = 0.03) and patients with longer time since disease diagnosis (p = 0.003), who showed higher satisfaction. Correlation between FIQR and PASS was weak and negative (r = -0.26), showing that alterations in FIQR are little related to patient satisfaction. There was statistical difference (p = 0.001) in FIQR scores between the satisfied and the not satisfied group, and also in scores from other questionnaires comparing both groups, showing that dissatisfied patients have lower quality of life. Strong correlation was demonstrated between FIQR and HAQ questionnaires (r = 0.68) and FIQR and Beck (r = 0.61). The value of best accuracy of FIQR in relation to PASS was 65 (ROC curve), but with low sensitivity and specificity. The best specificity values, which reflect values where 100% of patients are satisfied, were very low for each questionnaire. This sample showed low satisfaction, severe physical and psychological symptoms in fibromyalgia patients, suggesting reinforcement of non pharmacological strategies for the treatment of the disease. And that in studies addressing therapeutic measures for fibromyalgia, satisfaction measures should be used.