Open AccessImpact of fibromyalgia pain on health‐related quality of life before and after treatment with tramadol/acetaminophen
Author(s) -
Bennett Robert M.,
Schein Jeff,
Kosinski Mark R.,
Hewitt David J.,
Jordan Donna M.,
Rosenthal Norman R.
Publication year - 2005
Publication title -
arthritis care & research
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.21319
Subject(s) - medicine , fibromyalgia , acetaminophen , quality of life (healthcare) , tramadol , placebo , physical therapy , heart failure , randomized controlled trial , analgesic , population , anesthesia , alternative medicine , nursing , environmental health , pathology
Objective To assess health‐related quality of life (HRQOL) in patients with moderate‐to‐severe fibromyalgia pain compared with the general population, and to assess the relationship between pain severity and HRQOL before and after treatment with an analgesic. Methods Data were obtained from a randomized, double‐blind study of patients with moderate‐to‐severe fibromyalgia pain. Patients received either tramadol/acetaminophen or placebo 4 times/day as needed for 91 days. HRQOL was measured with the Short Form 36 Health Survey (SF‐36) and the Fibromyalgia Impact Questionnaire (FIQ). Baseline HRQOL scores were compared with a national sample of noninstitutionalized adults and a sample of patients with impaired HRQOL due to congestive heart failure. Patients with fibromyalgia were divided into tertiles by change in pain severity, and SF‐36 scores were compared across the tertiles. Mean changes in SF‐36 and FIQ scores were compared between treatment groups. Results Patients with fibromyalgia scored lower than the US norm on all SF‐36 scales ( P < 0.0001) and lower than patients with congestive heart failure on most scales. More severe pain was associated with greater impairment of HRQOL compared with less severe pain ( P < 0.0001). Patients in the highest tertile for improved pain severity had greater improvement in HRQOL scores than patients in the lower tertiles. Compared with patients who received placebo (n = 157), patients treated with tramadol/acetaminophen (n = 156) showed greater improvement on SF‐36 physical functioning, role physical, bodily pain, and physical summary scales, as well as FIQ scales for ability to do job, pain, and stiffness ( P < 0.01). Conclusion Moderate‐to‐severe fibromyalgia pain significantly impairs HRQOL, and effective pain relief in these patients significantly increases HRQOL.