Health inequities and societal costs for patients with fibromyalgia and their spouses: a Danish cohort study 2024 Amris et al

[Andy]

Abstract

Objective
To assess the burden of illness of people with fibromyalgia (FM) and their spouses compared with selected match populations in Denmark.

Methods
Population-based, cohort case-control study using data from Danish registries from 1994 to 2021. Individuals with an FM diagnosis were identified from the National Patient Register (2008–2019) and randomly matched to a 1:4 general population comparator. Spouses or persons co-living with subjects with FM at the time of diagnosis were compared with matched comparator spouses. Healthcare and societal costs, socioeconomic status and occurrence of comorbidities were evaluated for subjects with FM, spouses and controls.

Results
9712 subjects with FM (94.9% females, mean age 50 years) and 5946 spouses were included. At year of diagnosis, subjects with FM had significantly more comorbidities compared with controls, including significantly more comorbid rheumatic disorders. The highest risk at the time of FM diagnosis was a comorbid diagnosis of ankylosing spondylitis (OR 7.0, 95% CI 4.9 to 10.0). Significantly more comorbidities were also observed in spouses. Subjects with FM and spouses had higher healthcare and public transfer costs and lower income from employment at all timepoints. Loss of income from employment in subjects with FM occurred years before establishment of the FM diagnosis. The employment rate after diagnosis was 22%. 10 years after the FM diagnosis, 50% received disability pension as compared with 11% of matched controls. The observed net average increased societal cost for subjects with FM amounted to €27 193 per patient-year after diagnosis.

Conclusion
FM has major health and socioeconomic consequences for patients, their partners and society and call for improved healthcare strategies matching patients’ needs.

Open access, https://rmdopen.bmj.com/content/10/1/e003904

 

[rvallee]

FM has major health and socioeconomic consequences for patients, their partners and society and call for improved healthcare strategies matching patients’ needs.

What a novel, groundbreaking even, idea. Turns out that completely ignoring patients' needs isn't a good strategy. Like putting up nets to avoid smoke.

Now if only that didn't mean many more years of the same pseudoscience that completely ignores patients' needs in response because somehow that's all that medicine seems capable of doing here...

They write:

An early and tailored intervention would potentially assist patients to adjust to pain and adopt active self-management strategies preventing pain-related disability, including work disability and loss of employment

And that's great but you still have to actually come up with those interventions, in the form of effective treatments. Otherwise it's like saying we can solve climate change with nuclear fusion energy. Until commercially viable nuclear fusion energy is actually developed, it's an aspirational goal, not a plan.

Goals are not plans. They're very distinct things. Most of biopsychosocial stuff comes out as barely different than "if my grandmother had wheels she'd be a car". They have to come out of their damn loopy fantasy land before they can accomplish anything. So far the biopsychosocial ideology doesn't even have a single achievement under its belt, but they can't let go of it.

 

[Sean]

So far the biopsychosocial ideology doesn't even have a single achievement under its belt, but they can't let go of it.

Some have built glorious careers and empires and status and awards cabinets from it. Not to mention well above average incomes.

Which is why they can't let it go.