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Utilization of Healthcare Services and Drug Consumption in Fibromyalgia: A Cross-Sectional Analysis of the Clalit Health Service Database
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  • Omer Gendelman,
  • Raz Shapira,
  • Shmuel Tiosano,
  • Yuval Kuntzman,
  • Avishai Tsur,
  • Aliza Hakimian,
  • doron Comaneshter,
  • Arnon Cohen,
  • Dan Buskila,
  • Howard Amital
Omer Gendelman
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Raz Shapira
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Shmuel Tiosano
Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Yuval Kuntzman
Tel Aviv University Sackler Faculty of Medicine
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Avishai Tsur
Tel Aviv University Sackler Faculty of Medicine
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Aliza Hakimian
Tel Aviv University Sackler Faculty of Medicine
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doron Comaneshter
Clalit Health Services Tel Aviv
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Arnon Cohen
Clalit Health Services Tel Aviv
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Dan Buskila
Ben-Gurion University of the Negev
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Howard Amital
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Abstract

Abstract Aim: To investigate the health care utilization and drug consumption of patients with fibromyalgia (FM). Materials and Methods: This is a cross-sectional study using the Clalit Health Care database. Clalit is the largest HMO in Israel, serving more than 4.4 million enrollees. We identified FM patients and age and sex-matched controls. Indicators of healthcare utilization and drug consumption were extracted and analyzed for both groups. Results: The study included 14,296 FM patients and 71,324 controls. The mean age was 56 years, with a female predominance of 92%. The mean number of visits across of all healthcare services (hospitalizations, emergency department visit, general practitioner clinic visits, rheumatology clinic visits and pain clinic visits) and the mean difference (MD) were significantly higher for FM patients compared to controls (MD 0.66, p<0.001; MD 0.23, p<0.001; MD 7.49, p<0.001; MD 0.31, p<0.001; MD 0.13, p<0.001), respectively. Drug use was significantly and consistently higher among FM patients compared to controls; NSAIDs (non-steroidal anti-inflammatory drugs) OR 2.56, P<0.001; Opioids OR 4.23, P<0.001; TCA (tricyclic antidepressants) OR 8.21, P<0.001; Gabapentinoids OR 6.31, P<0.001; SSRI (selective serotonin reuptake inhibitors) OR 2.07, P<0.001; SNRI (serotonin-norepinephrine reuptake inhibitor) OR 7.43, P<0.001. Conclusion: Healthcare utilization and drug use are substantially higher among patients with fibromyalgia compared to controls

Peer review status:ACCEPTED

09 Jun 2021Submitted to International Journal of Clinical Practice
10 Jun 2021Submission Checks Completed
10 Jun 2021Assigned to Editor
04 Jul 2021Reviewer(s) Assigned
29 Jul 2021Review(s) Completed, Editorial Evaluation Pending
30 Jul 2021Editorial Decision: Revise Minor
06 Aug 20211st Revision Received
07 Aug 2021Submission Checks Completed
07 Aug 2021Assigned to Editor
07 Aug 2021Review(s) Completed, Editorial Evaluation Pending
09 Aug 2021Editorial Decision: Accept