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Cognitive-behavioural and social factors do not predict recurrent secondary healthcare use in patients with fibromyalgia: a longitudinal study
V.M. Vervoort1, J.E. Vriezekolk2, T.C. Olde Hartman3, T. Van Helmond4, W.H. Van Der Laan5, R. Geenen6, C.H. Van Den Ende7
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. j.vriezekolk@maartenskliniek.nl
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek, Woerden, The Netherlands.
- Department of Psychology, Utrecht University, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
CER11261
2019 Vol.37, N°1 ,Suppl.116
PI 0044, PF 0050
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PMID: 30557126 [PubMed]
Received: 20/03/2018
Accepted : 04/06/2018
In Press: 29/11/2018
Published: 08/02/2019
Abstract
OBJECTIVES:
Healthcare use in fibromyalgia (FM) is relatively high. Besides disease-related variables, cognitive-behavioural factors have been concurrently associated with healthcare use. It is unknown whether cognitive-behavioural and social factors also predict future healthcare use. The aim of this study was to identify cognitive-behavioural and social factors predicting recurrent secondary healthcare use in FM.
METHODS:
Using self-reported questionnaires, healthcare use, cognitive-behavioural, social, sociodemographic and disease-related variables including comorbidities were collected in 199 patients with FM, in a prospective longitudinal cohort spanning 18 months. Patients were recruited after receiving their diagnosis and protocolled treatment advice by a rheumatologist. Univariate and multivariate logistic regression models examined whether and which variables were predictors for recurrent secondary healthcare use. Internal validation was performed to correct for over-fit of the final multivariate model.
RESULTS:
Recurrent secondary healthcare use was lower than initial secondary healthcare use. Univariate analysis showed that having at least one comorbidity, depressive feelings, severe consequences of FM, low personal control and a high severity of fibromyalgia predicted recurrent secondary healthcare use. In the multivariate model, having at least one comorbidity was the only remaining predictor for recurrent secondary healthcare use.
CONCLUSIONS:
Our results suggest that the existence of comorbidities as communicated by the patient is the strongest warning signal for recurrent secondary healthcare use in FM. There seems no value in using cognitive-behavioural and social factors for early identification of patients with FM at risk for recurrent secondary healthcare use.