RISK OF FIBROMYALGIA IN RHEUMATOID ARTHRITIS PATIENTS IN TAIWAN: A NATIONWIDE POPULATION-BASED STUDY

Shu-Ching Chiu, MSN, Mei-Ling Lin, Ph.D,Shu-Chen Yang, MSN, Lee-Wen Pai, MSN, Chuan- Mei Chen, MSN, Horng-Mo Lee, Ph.D, Yueh-Chin Chung, Ph.D*

ABSTRACT

Background: The burden of Fibromyalgia (FM) with rheumatoid arthritis (RA) is sufficient to warrant recognition as a high-priority disorder in governmental health strategies. However, the components of RA patients with FM have not been studied extensively in Taiwan. Objective: We investigated the incidence rates, risk factors, healthcare utilization, and comorbidities of FM with RA in Taiwan. Methods: The data enrolled in the National Health Insurance Research Database from 1996 to 2010 were evaluated. The statistical methods included t test, ANOVA, and odds ratios with 95% confidence intervals (CIs). Results: A total of 873 RA patients with FM were women (75.4%), a health service utilization rate of 98.1% for Western medicine, and both Western (rate of 1.9%) and Chinese medicines (rate of 1.5%). In all year and age groups, the health service utilization rates were significantly higher for females than males (p < 0.05). The percentage rates were highest in people aged ≥ 75 years (25.7%). The affiliation-adjusted percentage rates were 34.2 in clinics and 31.4 in medical centers (p < 0.01). The disorders of the muscle, ligament, and fascia of FM with RA-to-RA odds ratio was 21.43 (95% CI 2.88–159.46). Conclusion: The mean annual incidence was 7.16 per 100,000 person /year. The findings may serve as data for 98.1% of Western medicine utilization among RA patients with FM, with peaks in the females, and clinics for treatment. Musculoskeletal disorder and anxiety were the most common comorbidities. Education program may help the RA patients with FM of life care.

Keywords: rheumatoid arthritis, fibromyalgia, incidence, health service utilization, comorbidities.