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. 2021 Nov;41(11):1995-2006.
doi: 10.1007/s00296-020-04702-5. Epub 2021 Mar 5.

Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective "real world" data analysis of fibromyalgia patients

Martin Offenbaecher  1   2 , Niko Kohls  3 , Thomas Ewert  4 , Claudia Sigl  5 , Robin Hieblinger  5 , Loren L Toussaint  6 , Fuschia Sirois  7 , Jameson Hirsch  8 , Miguel A Vallejo  9 , Sybille Kramer  5 , Javier Rivera  10 , Gerold Stucki  11 , Jörg Schelling  12 , Andreas Winkelmann  5
Affiliations

Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective "real world" data analysis of fibromyalgia patients

Martin Offenbaecher et al. Rheumatol Int. 2021 Nov.

Abstract

Objective: To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM).

Methods: In this cross-sectional, observational study, "real world" data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses.

Results: The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (- 0.22), pain-related interference with everyday life (- 0.19), general activity (0.13), general health perception (0.11), punishing response from others (- 0.11), work status (- 0.10), vitality (- 0.11) and cognitive difficulties (- 0.12). Pain intensity or frequency was not an independent correlate.

Conclusions: More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

Keywords: Chronic pain; Fibromyalgia; International classification of functioning; Multidisciplinary therapy; Predictors; Quality of life.

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