Do FIQR Severity Categories and Symptoms, Differentiate Between Continuous, Intermittent and Non-Opioid Users in the Treatment of Fibromyalgia?
Andrea R Pfalzgraf, Ronald Friend, Kimberly Dupree Jones
PMID 37993311WHAT IT FOUND
Fibromyalgia patients prescribed daily opioids reported worse physical function and global impact than intermittent or non-opioid users.
Pain locations were similar. 45% used opioids; 61% of those used them daily.
Key findings
0145% of respondents reported opioid use, with 27% continuous and 18% intermittent; among opioid users, 61% were continuous.
02Continuous opioid users had mean FIQR total scores of 73.9, compared with 65.9 for intermittent users and 65.7 for non-opioid users on a 0-100 scale; intermittent and non-opioid scores did not differ.
03Intermittent opioid users were more likely than continuous users to report difficulty obtaining opioid prescriptions (26.8% vs 18.6%) and to report using less medication than needed, hoarding, avoiding taking medication, or not filling prescriptions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey was self-selected and advertised through a natural medicine research page and a fibromyalgia newsletter, so it may not represent all people with fibromyalgia. It was cross-sectional, so it cannot show that opioid use caused worse symptoms or that severity led to prescribing. All measures were self-reported, including diagnosis, opioid use, stigma, and invalidation. The opioid stigma questions were adapted from a cancer study and were not validated for fibromyalgia. The study did not collect reasons for stigma behaviours, other treatments, or treatment satisfaction. The paper reports 1105 respondents in demographics but one severity analysis refers to 1054 participants, so the analysed sample is unclear.
Declared interests
The supplied metadata lists NIH extramural support; the article text does not report an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that continuous opioid use caused worse fibromyalgia or that stopping opioids improved symptoms. The study measured opioid use and severity at one time in a self-selected survey, so it can only show an association.