Rheumatology Clinic, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Jesi, Ancona, Italy.
Divisione di Reumatologia, ASST Gaetano Pini-CTO, Milano, Italy.
Clin Exp Rheumatol. 2020 Jan-Feb;38 Suppl 123(1):65-71. Epub 2020 Feb 12.
Fibromyalgia (FM), the most frequently encountered cause of widespread musculoskeletal pain, affects an estimated 2% of the general Italian population. However, it is not a homogeneous clinical entity, and a number of interacting factors can influence patient prognosis and the outcomes of standardised treatment programmes. Registries are a source of high-quality data for clinical research, but relating this information to individual patients is technically challenging. The aim of this article is to describe the structure and objectives of the first Italian Fibromyalgia Registry (IFR), a new web-based registry of patients with FM.
The IFR was developed to collect, store, and share information electronically entered by physicians throughout Italy who are members of the Italian Society of Rheumatology and have a particular interest in FM. It has a web-based architecture that uses two separate servers and an encryption algorithm to ensure the confidentiality and integrity of the exchanged data. The questionnaires included on the platform are the Revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status (ModFAS), and the Polysymptomatic Distress Scale (PDS).
The registry includes data relating to 2,339 patients (93.2% female) who satisfied the 1990 or 2010/2011 American College of Rheumatology Classification Criteria for Fibromyalgia at the time of diagnosis. At the time of this analysis, the patients had a mean age of 51.9 years (SD 11.5) and a mean disease duration of 7.3 years (SD 6.9). The majority were married (71.3%), and generally well educated. The overall median FIQR, ModFAS and PDS scores and 25th-75th percentiles were respetively 61.16 (41.16-77.00), 8.91 (41.16-77.00), and 19.0 (13.00-24.00). The six highest scoring items indicating the greatest impact of the disease on the patients related to fatigue/energy (7.18), sleep quality (6.87), tenderness (6.69), pain (6.68), stiffness (6.66), and environmental sensitivity (6.35). A high proportion of the responding patients reported experiencing pain in the neck (80.46%), upper back (68.36%), and lower back (75.05%).
The IFR is the most comprehensive FM registry in Italy, and provides healthcare professionals with a secure, reliable, and easy-to-use means of monitoring the patients' clinical progression, treatment history and treatment responses. This can help clinicians to plan patient management, facilitates research study patient recruitment, and provides the participating pain clinics with statistics based on real-world data. It also helps address the Italian Ministry of Health long-term goal of using precision medicine for chronic pain prevention and treatment. It is hoped that the IFR will enhance both scientific research and clinical practice.
纤维肌痛(FM)是最常见的广泛肌肉骨骼疼痛的原因,估计影响意大利总人口的 2%。然而,它不是一个同质的临床实体,许多相互作用的因素可以影响患者的预后和标准治疗方案的结果。登记处是临床研究高质量数据的来源,但将这些信息与个体患者相关联在技术上具有挑战性。本文的目的是描述第一个意大利纤维肌痛登记处(IFR)的结构和目标,这是一个新的基于网络的 FM 患者登记处。
IFR 旨在收集、存储和电子方式共享意大利风湿病学会成员的意大利医生输入的信息,这些医生对 FM 特别感兴趣。它具有基于网络的架构,使用两个单独的服务器和加密算法来确保交换数据的机密性和完整性。平台上包含的问卷是修订后的纤维肌痛影响问卷(FIQR)、改良纤维肌痛评估状况(ModFAS)和多症状困扰量表(PDS)。
该登记处包括 2339 名患者(93.2%为女性)的数据,他们在诊断时符合 1990 年或 2010/2011 年美国风湿病学会纤维肌痛分类标准。在本分析时,患者的平均年龄为 51.9 岁(SD 11.5),平均病程为 7.3 年(SD 6.9)。大多数患者已婚(71.3%),普遍受教育程度较高。总体中位数 FIQR、ModFAS 和 PDS 评分及 25 百分位至 75 百分位分别为 61.16(41.16-77.00)、8.91(41.16-77.00)和 19.0(13.00-24.00)。表明疾病对患者影响最大的六个最高得分项目与疲劳/能量(7.18)、睡眠质量(6.87)、压痛(6.69)、疼痛(6.68)、僵硬(6.66)和环境敏感性(6.35)有关。相当比例的应答患者报告颈部(80.46%)、上背部(68.36%)和下背部(75.05%)疼痛。
IFR 是意大利最全面的 FM 登记处,为医疗保健专业人员提供了一种安全、可靠、易于使用的监测患者临床进展、治疗史和治疗反应的方法。这有助于临床医生规划患者管理,促进研究患者招募,并为参与的疼痛诊所提供基于真实世界数据的统计信息。它还有助于实现意大利卫生部使用精准医学预防和治疗慢性疼痛的长期目标。希望 IFR 将增强科学研究和临床实践。