Comparing people who have and have not received a diagnosis of fibromyalgia: a cross-sectional survey within the PACFiND study.

Objective To compare impact of symptoms, and healthcare utilisation, of people diagnosed with fibromyalgia, people who fulfil criteria not diagnosed and people with chronic pain. Methods We recruited people who had participated in a previous population survey across Scotland and who reported some typical fibromyalgia symptoms or had received a diagnosis of fibromyalgia. Responses to a postal questionnaire were used to define mutually exclusive groups: people with a fibromyalgia diagnosis; who met criteria for fibromyalgia; with chronic pain. Results Participants included 85 people with a diagnosis of fibromyalgia, 110 who met criteria for fibromyalgia and 133 with chronic pain. Mean age across groups ranged 57-59 years, but the % female varied markedly: 86%, 64% and 67% respectively. Compared to those with chronic pain, participants with a fibromyalgia diagnosis were more likely to be out of employment due to health. It took an average of three years to receive a fibromyalgia diagnosis and more than half were diagnosed in secondary care (most commonly rheumatology). The fibromyalgia diagnosis and criteria groups were similar in terms of symptom impact, quality of life and life satisfaction, but were worse than the chronic pain group. Participants who had received a diagnosis of fibromyalgia reported the poorest health care experiences. Conclusion There is an urgent need for a model of care for fibromyalgia to ensure prompt diagnosis, access to evidence-based care and long-term support, with the aim of improving function. The data suggest that diagnosis in men may be overlooked and this warrants further study.