Department of Rheumathology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Int J Rheum Dis. 2017 Dec;20(12):1917-1921. doi: 10.1111/1756-185X.12716. Epub 2015 Jul 22.
Fibromyalgia syndrome (FMS) is a common rheumatologic disorder characterized by easy fatigability, widespread musculoskeletal pain and sleep disorder. In spite of its high prevalence, general practitioners, as primary care providers, seem to have inadequate knowledge about FMS. This study aimed to assess Iranian general practitioners' knowledge about FMS and its treatment.
A detailed questionnaire (including items on signs and symptoms, diagnostic criteria and treatment) was completed by 190 general practitioners (54.7% male; mean age: 41 years). Data analysis was performed with SPSS for Windows 15.0 and awareness about all aspects of FMS was reported as percentages.
About one-third (30%) of the participants had seen at least one case of FMS during their practice. Most subjects (62.7%) claimed to know 1-6 tender points. Only 3.2% knew 16-18 points. The common proposed symptoms of FMS were widespread pain (72.6%), excessive fatigue (72.6%), weakness (60.5%), sleep disorder (36.3%), anxiety (34.7%) and depression (34.2%). Wrong symptoms including elevated erythrocyte sedimentation rate and C-reactive protein, arthritis, joint swelling, weight loss and abnormal radiologic findings were selected by 27.9%, 18.9%, 14.7%, 12.6% and 2.1% of the physicians, respectively. Moreover, selective serotonin reuptake inhibitors, tricyclic antidepressant and pregabalin were identified as treatment options for FMS by, respectively, 45.8%, 22.1% and 15.3% of the participants. Finally, 52.1% and 23.7% of the subjects incorrectly considered nonsteroidal anti-inflammatory drugs and corticosteroids as treatment modalities for FMS.
Iranian general practitioners are not well informed about FMS. Therefore, FMS should be specifically integrated in continuing medical education programs and undergraduate medical training curriculum.
纤维肌痛综合征（FMS）是一种常见的风湿性疾病，其特征为易疲劳、广泛的肌肉骨骼疼痛和睡眠障碍。尽管其患病率较高，但作为初级保健提供者的全科医生似乎对 FMS 的了解不足。本研究旨在评估伊朗全科医生对 FMS 及其治疗的了解。
190 名全科医生（54.7%为男性；平均年龄：41 岁）填写了详细的问卷（包括体征和症状、诊断标准和治疗）。使用 SPSS for Windows 15.0 进行数据分析，报告 FMS 所有方面的知晓率为百分比。
约三分之一（30%）的参与者在其行医过程中至少见过一例 FMS。大多数受试者（62.7%）声称知道 1-6 个压痛点。只有 3.2%知道 16-18 个点。FMS 的常见提出症状为广泛疼痛（72.6%）、过度疲劳（72.6%）、虚弱（60.5%）、睡眠障碍（36.3%）、焦虑（34.7%）和抑郁（34.2%）。27.9%、18.9%、14.7%、12.6%和 2.1%的医生分别选择了错误的症状，包括红细胞沉降率和 C 反应蛋白升高、关节炎、关节肿胀、体重减轻和异常放射学发现。此外，45.8%、22.1%和 15.3%的参与者分别将选择性 5-羟色胺再摄取抑制剂、三环类抗抑郁药和普瑞巴林确定为 FMS 的治疗选择。最后，52.1%和 23.7%的受试者错误地认为非甾体抗炎药和皮质类固醇是 FMS 的治疗方法。
伊朗全科医生对 FMS 的了解不足。因此，应将 FMS 专门纳入继续医学教育计划和本科医学培训课程。
