ARHP is sponsoring Evidence-Based Clinician Education for Diagnosing and Treating Fibromyalgia, an education program for health care providers. The expected outcome of the program is improved provider competence and performance in primary care practice to (1) effectively identify and diagnose fibromyalgia in female patients, and (2) employ a patient-centered approach to managing fibromyalgia and facilitating patients’ compliance with treatment.

For more information about the program, please contact Delysha D’Mellow Henry at dhenry@arhp.org or (202) 466-3825.

Background

Fibromyalgia is a chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points in the body. An estimated 3-6 million Americans cope with this debilitating syndrome annually—of these, nearly 90 percent are women. Although its etiology is unknown, women are more at risk for developing fibromyalgia particularly during their reproductive and early menopausal years. In an ongoing effort to ensure optimal patient care ARHP has created a continuing education program to educate clinicians who encounter patients suffering from the myriad symptoms of fibromyalgia in order to improve the diagnosis and management of this painful condition. Through the use of ARHP’s Virtual Clinic (vClinic), this accredited educational program aims to close the gaps between current and best practices for the primary care management of fibromyalgia in women by (1) expanding providers’ knowledge about the symptoms of fibromyalgia, diagnostic strategies, and the importance of early treatment; (2) improving providers competence with diagnosing fibromyalgia and implementing effective patient-centered approaches for treatment.

Fibromyalgia is the most common cause of nonspecific pain among adult women in the United States. Primary care providers (PCPs) are often the first to see women who are experiencing symptoms of fibromyalgia; when diagnosed appropriately soon after onset, this condition can be well managed in primary care. Yet many patients with fibromyalgia suffer for years without a diagnosis, mainly because many PCPs lack a solid understanding of this complex disorder and how to implement best practices for treatment.

As many as 10 million US adults suffer from fibromyalgia, with women affected 10 times as often as men. Patients often present to their PCP with widespread pain, fatigue, sleep trouble, and a host of symptoms found in other hard-to-diagnose pain disorders such as bladder and pelvic pain, irritable bowels, and recurrent headaches . Women suffering from fibromyalgia are also more likely to experience depression, sexual dysfunction, and substance abuse, which can further contribute to overall poor quality of life.

Once diagnosed, primary care is an ideal setting for managing fibromyalgia. But making a diagnosis can be difficult—there are no diagnostic tests for fibromyalgia, so PCPs must be able to conduct appropriate musculoskeletal examinations and take patient-reported symptoms into account. Unfortunately, we know that PCPs often lack the awareness and skills necessary to effectively identify fibromyalgia; as a result, many patients remain untreated for months or even years. Given the painful and often disruptive effects of fibromyalgia, it is critical for primary care providers to screen symptomatic patients so they can initiate treatment as early as possible.

Program Design and Educational Activities

Previous program components include:

1. PowerPoint slide set with talking points, case studies, and learning activities
2. Live visiting faculty sessions
3. Live and archived webinar sessions
4. Integration of slide set into CORE, ARHP’s on-line, open-access collection of peer-reviewed, evidence-based teaching materials
5. A Performance Improvement Program

New program components include:

1. Live panel presentation at Reproductive Health 2011
2. Expansion of the ARHP Virtual Clinic

This case-based continuing education program utilizes RealCME, an interactive, self-directed program through which participants virtually interact with multiple patients in a virtual clinic (vClinic). The vClinic is designed to replicate the real-world experiences of busy clinicians, enabling learners to “meet and care for” patients over several visits. This web-based platform incorporates key principles of adult learning theory by enabling participants to actively apply their knowledge to relevant situations at a self-controlled pace.4 The vClinic (click here) is available at no cost through ARHP’s Web site.

Curriculum Learning Objectives

At the conclusion of the medical education sessions, providers will be able to:

• Expand their knowledge about the symptoms of fibromyalgia, diagnostic strategies, and the importance of early treatment
• Improve their competence with diagnosing fibromyalgia and implementing effective patient-centered approaches for treatment.

Intended Audience and Accreditation

This program includes educational offerings for members of the primary care team who provide health services and education to women throughout the lifespan (physicians, nurse practitioners, physician assistants, nurses, and support staff who practice in ob/gyn, family medicine, internal medicine, and related settings).

Funding

This project is funded through an educational grant from Pfizer.