Patients with fibromyalgia attending primary care based education seminars and workshops

Purpose

To ascertain patient feedback following their attendance at education seminars “Understanding Fibromyalgia”, “The role of medications in the management of Fibromyalgia” and a 'Moving forwards workshop' for people with a diagnosis of Fibromyalgia Syndrome (FMS). This is a change from usual practice where patients were seen in specialist secondary care by a member of the medical team. Education and exercise are now prioritised as first-line interventions.

Approach

Data collected consisted of self-reported quantitative visual analogue scales rating their overall satisfaction (n= 159) and qualitative reports of patient experiences. Semi-structured interviews (n=12) were conducted by telephone. Patients were asked 4 questions:

  1. How useful was the pre seminar information?
  2. Did extra topics need to be included in the seminars?
  3. How were they referred to the FMS service?
  4. What involvement/relationship do they have with their GP for your FMS pathway?

Five qualitative themes emerged from the semi-structured interviews with regard to the patient's relationship with their GP.

Outcomes

Patients (n=159) were asked to rate seminars and workshops on a scale of 1-10 where 10/10 was 'very helpful'. Average ratings for the seminars were “Understanding Fibromyalgia” (8.75/10), “The role of medications in the management of Fibromyalgia” (8.7/10) and the “Moving Forwards with Fibromyalgia” Workshop (8/10). 75% reported that information was useful pre seminar; 56% were satisfied that no extra topics were required.

Referrals were primarily from GPs (45%) and specialist pain team (44%) with 11% from Physiotherapy Outpatient teams. Only 22% reported that they have a positive relationship with their GP. The five qualitative themes that emerged when patients were asked about their GP were:

  1. 'Lack of support from the GP' (24%), 'supportive GP' (10%),
  2. 'Lack of access to the GP' (14%),
  3. 'Lack of continuity to see the same GP' (33%), and
  4. 'lack of awareness of Fibromyalgia Syndrome' (19%).

Patients reported that “The GP did not believe me at first”; “I see 2 GPs who have been really helpful and understanding”; “It is difficult to get access to see your own GP”; “I have to tell different GPs my story multiple times as I see different GPs each time I go to the surgery”; “I learnt more about FM from Google than my GP”.

Cost and savings

Patients are satisfied with the information provided at the education seminars and feel empowered to self-manage their Fibromyalgia condition. However, some patients describe their relationship with their GP as being challenging and frustrating. Future focus groups with patients and GP's are proposed to further validate the qualitative themes.

Implications

Patients with Fibromyalgia have been diverted from usual specialist secondary medical care and are now being offered therapy-based treatment options within community and primary care. Improving the patient's relationship with their GP is a vital component of providing successful primary care.

Fund acknowledgements

This work was not funded.

Additional notes

This work was presented at Physiotherapy UK 2018.