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ACR 2016 Fibromyalgia Diagnostic Criteria
The 2010/2011 ACR guidance document suggested replacing the tender point score with a questionnaire based solution to picking up a potential fibromyalgia diagnosis. The adoption of this has been slow and the physical assessment nature of the tender point score still has some merit in some cases. We switched soon after the 2011 paper and the 2016 update has made the criteria quicker to perform and more patient friendly.
The corona virus pandemic mandated switch to telephone and video consults should be the end of the use of the trigger point score and full adoption of the preferentially recommended diagnostic criteria. Whilst we'd usually get this completed by the patient in the wait room when we used to do face-to-face, the ability to complete over the phone has been successfully trialed with good clinician and patient feedback.
What is needed to sustain the change?
Widespread adoption of the 2016 ACR fibromyalgia diagnostic criteria across the the rheumatology and msk assessment pathways. Ability to use this over the phone (or video) during the appointment or, perhaps preferentially, over the internet pre-appointment.
What is your region?
North West
Hi Will
thanks for sharing
We've been using this questionnaire within our community pain setting and agree that the real value is getting patients to fill it in and the challenge is how we do this with remote appts. I'm slightly nervous about sending it out to new patients ahead of their initial assessment as the assumption is being made that the diagnosis if FM and often the question we're being asked as rheumatologist is that the diagnosis is secure and "nothing else" is being missed..... We're using the AttendAnywhere platform for our video consultations and would be great to share a PROM such as this through that platform and get the patient to complete at the appropriate time during the consultation but not aware that this is possible.
I'm thinking this could also apply to completing BASDAI, though we're keen to get these pushed out to patients to complete ahead of appts...….
Is there any restriction with regards to the license for the FM questionnaire?
Lizzy MacPhie
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Hi Will and Lizzy
One of the challenges which has been discussed locally is the need expressed on Pain Management pathways to have the reassurance of the diagnosis of fibromyalgia made by a rheumatologist, along with their exclusion of other conditions before being accepted onto the pathway.
Is there adequate evidence or clinical confidence in a screening /diagnosis strategy /model that could reduce the need for a Consultant Rheumatologist assessment for many of these people with suspected FMS or non-inflammatory wide spread pain problems- any thoughts would be great.
Thank you for your comments
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Status labels added: Guidance, Information Sharing, Patient Activation, Virtual Consulting, Horizon 1
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Status labels removed: Guidance, Information Sharing, Patient Activation, Virtual Consulting
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