The FIBRO System: a rapid strategy for assessment and management of fibromyalgia syndrome

Abstract

Fibromyalgia syndrome (FMS) is a complex disorder of widespread pain and tenderness associated with numerous other symptoms including fatigue, cognitive dysfunction, nonrestorative sleep, depression, anxiety, and stiffness. While new diagnostic criteria and previous management guidelines require quantitation of the severity of associated FMS symptoms experienced by individual patients, no system for rapid patient assessment has been made available to provide a basis for diagnosis, treatment selection and follow-up for clinicians in busy practices who have limited time. This review presents the FIBRO System, an easily remembered system for FMS symptom quantitation using the FIBRO mnemonic along with verbal questions on simple 0 10 scales to assess symptom severity (the FIBRO Problem Scale) and response to treatment (the FIBRO Change Scale) along with recommendations for pharmacologic and nonpharmacologic therapies to address individual FIBRO symptoms. This symptom-based approach can improve the care of FMS patients by providing a comprehensive, focused assessment in limited time.

Simplifying fibromyalgia assessment: the VASFIQ Brief Symptom Scale

“…VASFIQ completion requires self-administration of a paper questionnaire and VAS scoring requires distance measurement with a ruler, both of which can be cumbersome to perform in the clinic setting. Oral administration of the VASFIQ using a 010 numeric rating scale has been proposed as a way to circumvent these issues [Boomershine, 2010;Boomershine and Crofford, 2009]. However, since oral administration would require changes to the VASFIQ, including addition of a small introductory explanation and third-person wording of the items, validation of an interviewer-administered version is needed before it can be recommended.…”

“…This is an important limitation of using VASs in FM management, because medications that improve some FM symptoms often worsen other symptoms and many patients with FM have high baseline VAS scores. A revision of the VASFIQ that utilizes more extreme wording for the upper anchors to decrease ceiling effects and a patient impression of change format at follow up has been proposed to improve assessment of symptom worsening in patients with FM [Boomershine, 2010], but this revision needs to be validated.…”

“…Two revisions of the FIQ VASs have sought to address these limitations [Boomershine, 2010;Bennett et al 2009]. A revision of the FIQ (FIQR) has been developed recently that provides a rapid alternative to the full-length FIQ [Bennett et al 2009].…”

The Use of Polysymptomatic Distress Categories in the Evaluation of Fibromyalgia (FM) and FM Severity

“…We have suggested that for clinical practice (and probably for research), a common set of simple variables that can be used across all rheumatic diseases and pain illness, rather than disease-specific variables, can be an effective way to evaluate patients 31 . Boomershine has reviewed comprehensive assessment tools in FM 32 and proposed a 7-item VAS scale assessment tool based on an older, shortened version of the FIQ 33,34 .…”

Untersuchung der Wirksamkeit biomechanischer Stimulationstherapie bei Fibromyalgie-Syndrom

“…Mit dieser besonders günstigen Art der Evaluation von Therapieveränderungen kann der sogenannte high ceiling effect umgangen werden, da bei schwerer Symptomatik und entsprechend maximalen Baseline-Werten durch Interventionen bewirkte Verbesserungen oder Verschlechterungen der Beschwerden erneut mit der Angabe maximaler Werte einhergehen und so durch eine Therapie erzielte Veränderungen nicht erfasst werden können. Der FCS enthält 7 numerische Rangskalen (NRS), welche die Kernsymptome Schmerz, Erschöpfung/Müdigkeit, Schlaf, Depression, innere Unruhe/Nervosität, Steifigkeit und kognitive Dysfunktion erfassen [20,23]. Die 7 Elemente des validierten FCS wurden in dieser Studie um ein weiteres ergänzt, das die Veränderungen der lokalen Schmerzintensität im Bereich der Ellenbogen erfasst (FCS lokal).…”