Case Study Diana Baylis and Erica Olson July 26, 2010 Case Study PHC6000- Managerial Epidemiology We pledge that we have not plagiarized on any aspect of this assignment. Executive Summary
Fibromyalgia is a chronic pain disorder that affects approximately 10 million people in the United States, and approximately 3-6% of the world population (NFA, 2009). It affects people physically, mentally, and socially (NFA, 2009). Fibromyalgia is a very hard condition to diagnose, since there are so many risk factors that contribute to the condition, fibromyalgia can go undiagnosed or misdiagnosed for years (NFA, 2009). Currently, the main issues are, should there be more physician offices opened that specialize in fibromyalgia or should more alternative therapies such as pain management and massage parlors cater to fibromyalgia patients, or should more preventative or public health measures be set in place for communities to make the population more aware of the condition and educate them about preventative measures that can be taken? This case study will consist of five different sections. The first sections will discuss the background of fibromyalgia and whom it affects. The second section will identify the problem for our case study. It addresses the current issues that taking place in regards to the disease. The third section will explain the risk factors of fibromyalgia. The purpose of this section will be to identify the main risk factors that contribute to fibromyalgia. The fourth section of our case study will discuss how many people roughly in Florida have other rheumatic/arthritic disorders. The last section of our paper will identify what preventative measures can be set up in the community to minimize the effects of fibromyalgia. The purpose of this section will be to help individuals answer the questions for the current issues that are occurring.
Background Fibromyalgia affects approximately 10 million people in the United States, and approximately 3-6% of the world population (NFA, 2009). Women are more prevalent to suffer from fibromyalgia than men, but men and children have been known to suffer from fibromyalgia (NFA, 2009). Also, it is estimated that between 75-90 percent of the people who have fibromyalgia are women (NFA, 2009). Furthermore, individuals who are diagnosed with this condition are between the ages of 20 to 50, and the incidence of the condition increases with age (NFA, 2009). Finally, it is estimated that approximately 8% of adults, 80 years of age and older, meet the criteria set by the American College of Rheumatology for having fibromyalgia (NFA, 2009) .
Problem
Fibromyalgia is a very hard condition to diagnose, since there are so many risk factors that contribute to the condition, fibromyalgia can go undiagnosed or misdiagnosed for many years. The problems for many patients who suffer from fibromyalgia or who are high risk for this condition really have no place to go for proper treatment. There are few physicians who diagnosis and treat this condition. Currently, there are roughly 13-15 physicians in Central Florida that diagnose and treat fibromyalgia (NFA, 2009). The main issues are, should there be more physician offices opened that specialize in fibromyalgia or should more alternative therapies offices such as pain management and massage parlors cater to fibromyalgia patients, or should more preventative or public health measures be set in place for communities to make the population more aware of the condition and educate them about preventative measures that can be taken?
What are the Risk Factors?
The risk factors of fibromyalgia must be identified to ensure this specific population receives the quality of care they deserve. The main risk factors that contribute to fibromyalgia are age, gender, physical and emotional trauma, illness and infections, other rheumatic diseases (e.g. lupus and rheumatoid arthritis), and family history (Mayo Clinic, 2010).
How many people roughly in Florida have other rheumatic/arthritic disorders?
BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM FLORIDA CORE QUESTIONS DATA REPORT, 2009 SECTION 17: ARTHRITIS BURDEN TABLE 1: HAVE YOU EVER BEEN TOLD BY A DOCTOR OR OTHER HEALTH PROFESSIONAL THAT YOU HAVE SOME FORM OF ARTHRITIS, RHEUMATOID ARTHRITIS, GOUT, LUPUS, OR FIBROMYALGIA? (HAVARTH2) Denominator excludes: Respondents with do not know/refused/missing responses NOTE: % = Percentage, C.I.(95%) = Confidence Interval (at 95 percent probability level). Percentages are weighted to population characteristics.
Yes
No
Respondent Total
Number Weighed
N
%
C.I. (95%)
N
%
C.I. (95%)
Total
11528
13,841,344
4531
27
25.6-28.4
6997
73
71.6-74.4
Men
4346
6,659,408
1498
23.8
21.6-26.0
2848
76.2
74.0-78.4
Women
7182
7,181,936
3033
29.9
28.1-31.7
4149
70.1
68.3-71.9
[Information Source: Florida Department of Health, 2010].
FLORIDA ADULTS >18 WITH DOCTOR-DIAGNOSED ARTHRITIS (DRDX+), BRFSS 2007
3,321,000 adults have doctor diagnosed arthritis; 24% of all adults have DRDX+
1,374,000 men have DRDX+ (21%)
1,947,000 women have DRDX+ (28%)
550,000 adults 18-44 have DRDX+ ( 9%)
1,314,000 adults 45-64 have DRDX+ (30%)
1,438,000 adults 65 and older have DRDX+ (48%)
2,503,000 non-Hispanic white adults have DRDX+ (28%)
256,000 non-Hispanic black adults have DRDX+ (20%)
390,000 Hispanic adults have DRDX+ (15%)
386,000 adults with less than a high school education have DRDX+ (30%)
975,000 adults with a high school education have DRDX+ (25%)
1,952,000 adults with more than a high school education have DRDX+ (23%)
985,000 obese adults have DRDX+ (32%)
682,000 adults who are physically inactive have DrDX+
32% of adults who are physically inactive have DrDX+
[Information Source: Centers for Disease Control and Prevention, October 28, 2009].
Approximately one in 50 people are estimated to have fibromyalgia (MyFibro.com, 2010). According the US Census Bureau (2006-2008), there is an estimated 18,182,321 people who reside in the state of Florida. Out of that estimated population in Florida, 9,255,906 are women, respectively (US Census Bureau, 2006-2008). Since, women are more prevalent to fibromyalgia, and it is estimated that one in 50 have fibromyalgia, it could be estimated that approximately 185,118 women in the state of Florida could be afflicted by this condition. However, according to the CDC in 2007 (2009),1,947,000 women 18 and older in Florida were reported to have arthritis, which had been diagnosed by a physician. Since, fibromyalgia co-occurs with other rheumatic and arthritic conditions, these individuals could be at higher risk to develop the condition (Mayo Clinic, 2010). Furthermore, an estimated 38,940 of these patients diagnosed with arthritis could develop fibromyalgia.
What preventative measures can be set up in the community to minimize the effects of fibromyalgia?
There is no particular way an individual can avoid getting fibromyalgia. However, just like preventing any other health condition, it is important for any individual to have a good diet, exercise, and get plenty of rest. Following these guidelines will help prevent any type of medical condition, including fibromyalgia (Testing for Fibromyalgia, 2010). Even though preventive strategies for fibromyalgia are difficult because the cause of it is unknown, there are public health interventions that are available. They would consist of better access to care, such as FDA approved medications for the treatment of fibromyalgia. Additionally, there are some minority groups who keep women from seeking medical help when they are in pain. Educating them as well as others on the tolerance and recognition of fibromyalgia would be a public health intervention. There is also counseling available for individuals who have been diagnosed with fibromyalgia. This helps the patient adjust to a lifestyle of living in chronic pain (Testing for Fibromyalgia, 2010). In addition to the aforementioned preventative and public health interventions, fibromyalgia patients can cope with the condition through other programs, such as stress management and alternative therapies (NFA, 2009). However, even though there are preventative measures and public health interventions available, these programs must be made accessible to individuals who suffer and who are high risk candidates for fibromyalgia.
Appendix The reason Diana and I chose to research fibromyalgia for our topic for the class was because neither one of us knew much about the condition. Also, it is a very rare condition, which made it appealing to us. Overall, we were both very interested to learn about fibromyalgia, and the mystery behind the condition. We chose to work together because we were working on another assignment together in one of our other classes. Since we already knew each other, it made it easier to work together for the assignments in this class. Another reason that we chose to work together was because we live very close to each other. This made it easier for communicating and gathering information. Although we did not have to meet with each other in order to complete any of the projects, we decided that living close to one another would be an advantage if for some reason we needed to meet. For the case study, we decided that it would be best to divide up the work. Since most of the research had already been done on the topic for our Epidemiology Paper, there was not much left to do. Diana worked hard trying to contact someone in order to find specific numbers relating to the number of individuals in Florida that had other rheumatic/arthritic disorders. She also worked on the layout of the paper and put all the information that we already had in the correct section. Diana put together the background of our case study, the problem, and the risk factors. I worked on the preventative measures that could be set up in the community to minimize the effects of fibromyalgia. After we gathered all of our necessary information, Diana composed the three questions and teaching notes with the proposed answers. Since Diana had worked hard on putting our paper together, I took the initiative to complete the executive summary. As far as the discussion board and Wiki were concerned, we posted to both of them to help compose our paper. Diana posted first on the Wiki and I added information about risk factors and preventative measures. This helped to compose our paper and put it in the correct order. We did not use the discussion board as much for the case study as we did for the epidemiology paper. Instead, we relied on course e-mail. This allowed us to send information back and forth and then we could each respond in an appropriate time. Diana and I worked very well together. We both worked diligently and got everything done in the required amount of time. Using the discussion board and Wiki was also a very useful tool that can be used for future assignments in other classes. After completing both of these assignments, I feel that we both learned a lot of information about fibromyalgia.
Diana Baylis and Erica Olson
July 26, 2010
Case Study
PHC6000- Managerial Epidemiology
We pledge that we have not plagiarized on any aspect of this assignment.
Executive Summary
Fibromyalgia is a chronic pain disorder that affects approximately 10 million people in the United States, and approximately 3-6% of the world population (NFA, 2009). It affects people physically, mentally, and socially (NFA, 2009). Fibromyalgia is a very hard condition to diagnose, since there are so many risk factors that contribute to the condition, fibromyalgia can go undiagnosed or misdiagnosed for years (NFA, 2009). Currently, the main issues are, should there be more physician offices opened that specialize in fibromyalgia or should more alternative therapies such as pain management and massage parlors cater to fibromyalgia patients, or should more preventative or public health measures be set in place for communities to make the population more aware of the condition and educate them about preventative measures that can be taken?
This case study will consist of five different sections. The first sections will discuss the background of fibromyalgia and whom it affects. The second section will identify the problem for our case study. It addresses the current issues that taking place in regards to the disease. The third section will explain the risk factors of fibromyalgia. The purpose of this section will be to identify the main risk factors that contribute to fibromyalgia. The fourth section of our case study will discuss how many people roughly in Florida have other rheumatic/arthritic disorders. The last section of our paper will identify what preventative measures can be set up in the community to minimize the effects of fibromyalgia. The purpose of this section will be to help individuals answer the questions for the current issues that are occurring.
Background
Fibromyalgia affects approximately 10 million people in the United States, and approximately 3-6% of the world population (NFA, 2009). Women are more prevalent to suffer from fibromyalgia than men, but men and children have been known to suffer from fibromyalgia (NFA, 2009). Also, it is estimated that between 75-90 percent of the people who have fibromyalgia are women (NFA, 2009). Furthermore, individuals who are diagnosed with this condition are between the ages of 20 to 50, and the incidence of the condition increases with age (NFA, 2009). Finally, it is estimated that approximately 8% of adults, 80 years of age and older, meet the criteria set by the American College of Rheumatology for having fibromyalgia (NFA, 2009) .
Problem
Fibromyalgia is a very hard condition to diagnose, since there are so many risk factors that contribute to the condition, fibromyalgia can go undiagnosed or misdiagnosed for many years. The problems for many patients who suffer from fibromyalgia or who are high risk for this condition really have no place to go for proper treatment. There are few physicians who diagnosis and treat this condition. Currently, there are roughly 13-15 physicians in Central Florida that diagnose and treat fibromyalgia (NFA, 2009). The main issues are, should there be more physician offices opened that specialize in fibromyalgia or should more alternative therapies offices such as pain management and massage parlors cater to fibromyalgia patients, or should more preventative or public health measures be set in place for communities to make the population more aware of the condition and educate them about preventative measures that can be taken?
What are the Risk Factors?
The risk factors of fibromyalgia must be identified to ensure this specific population receives the quality of care they deserve. The main risk factors that contribute to fibromyalgia are age, gender, physical and emotional trauma, illness and infections, other rheumatic diseases (e.g. lupus and rheumatoid arthritis), and family history (Mayo Clinic, 2010).
How many people roughly in Florida have other rheumatic/arthritic disorders?
BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEMFLORIDA CORE QUESTIONS DATA REPORT, 2009
SECTION 17: ARTHRITIS BURDEN
TABLE 1: HAVE YOU EVER BEEN TOLD BY A DOCTOR OR OTHER HEALTH PROFESSIONAL THAT YOU HAVE SOME FORM OF ARTHRITIS, RHEUMATOID ARTHRITIS, GOUT, LUPUS, OR
FIBROMYALGIA? (HAVARTH2)
Denominator excludes: Respondents with do not know/refused/missing responses
NOTE:
% = Percentage, C.I.(95%) = Confidence Interval (at 95 percent probability level). Percentages are weighted to population characteristics.
FLORIDA ADULTS >18 WITH DOCTOR-DIAGNOSED ARTHRITIS (DRDX+), BRFSS 2007
(STANDARD TABLE 1)
Approximately one in 50 people are estimated to have fibromyalgia (MyFibro.com, 2010). According the US Census Bureau (2006-2008), there is an estimated 18,182,321 people who reside in the state of Florida. Out of that estimated population in Florida, 9,255,906 are women, respectively (US Census Bureau, 2006-2008). Since, women are more prevalent to fibromyalgia, and it is estimated that one in 50 have fibromyalgia, it could be estimated that approximately 185,118 women in the state of Florida could be afflicted by this condition. However, according to the CDC in 2007 (2009),1,947,000 women 18 and older in Florida were reported to have arthritis, which had been diagnosed by a physician. Since, fibromyalgia co-occurs with other rheumatic and arthritic conditions, these individuals could be at higher risk to develop the condition (Mayo Clinic, 2010). Furthermore, an estimated 38,940 of these patients diagnosed with arthritis could develop fibromyalgia.What preventative measures can be set up in the community to minimize the effects of fibromyalgia?
There is no particular way an individual can avoid getting fibromyalgia. However, just like preventing any other health condition, it is important for any individual to have a good diet, exercise, and get plenty of rest. Following these guidelines will help prevent any type of medical condition, including fibromyalgia (Testing for Fibromyalgia, 2010).
Even though preventive strategies for fibromyalgia are difficult because the cause of it is unknown, there are public health interventions that are available. They would consist of better access to care, such as FDA approved medications for the treatment of fibromyalgia. Additionally, there are some minority groups who keep women from seeking medical help when they are in pain. Educating them as well as others on the tolerance and recognition of fibromyalgia would be a public health intervention. There is also counseling available for individuals who have been diagnosed with fibromyalgia. This helps the patient adjust to a lifestyle of living in chronic pain (Testing for Fibromyalgia, 2010).
In addition to the aforementioned preventative and public health interventions, fibromyalgia patients can cope with the condition through other programs, such as stress management and alternative therapies (NFA, 2009). However, even though there are preventative measures and public health interventions available, these programs must be made accessible to individuals who suffer and who are high risk candidates for fibromyalgia.
Appendix
The reason Diana and I chose to research fibromyalgia for our topic for the class was because neither one of us knew much about the condition. Also, it is a very rare condition, which made it appealing to us. Overall, we were both very interested to learn about fibromyalgia, and the mystery behind the condition.
We chose to work together because we were working on another assignment together in one of our other classes. Since we already knew each other, it made it easier to work together for the assignments in this class. Another reason that we chose to work together was because we live very close to each other. This made it easier for communicating and gathering information. Although we did not have to meet with each other in order to complete any of the projects, we decided that living close to one another would be an advantage if for some reason we needed to meet.
For the case study, we decided that it would be best to divide up the work. Since most of the research had already been done on the topic for our Epidemiology Paper, there was not much left to do. Diana worked hard trying to contact someone in order to find specific numbers relating to the number of individuals in Florida that had other rheumatic/arthritic disorders. She also worked on the layout of the paper and put all the information that we already had in the correct section. Diana put together the background of our case study, the problem, and the risk factors. I worked on the preventative measures that could be set up in the community to minimize the effects of fibromyalgia. After we gathered all of our necessary information, Diana composed the three questions and teaching notes with the proposed answers. Since Diana had worked hard on putting our paper together, I took the initiative to complete the executive summary.
As far as the discussion board and Wiki were concerned, we posted to both of them to help compose our paper. Diana posted first on the Wiki and I added information about risk factors and preventative measures. This helped to compose our paper and put it in the correct order. We did not use the discussion board as much for the case study as we did for the epidemiology paper. Instead, we relied on course e-mail. This allowed us to send information back and forth and then we could each respond in an appropriate time.
Diana and I worked very well together. We both worked diligently and got everything done in the required amount of time. Using the discussion board and Wiki was also a very useful tool that can be used for future assignments in other classes. After completing both of these assignments, I feel that we both learned a lot of information about fibromyalgia.
References
Centers for Disease Control and Prevention. (2009, October 28). Data and Statistics. Retrieved on July 22, 2010 from http://www.cdc.gov/arthritis/data_statistics/summary/fl.htm.
Florida Department of Health. (2010, June 30). Behavioral Risk Factor Surveillance System: Florida Core Questions Data Report, 2009. Retrieved on July 22, 2010 from http://www.doh.state.fl.us/disease_ctrl/epi/brfss/CDC_Summary_Pages/2009_CDC/Arthritis.pdf.
Mayo Clinic (2010, April). Fibromyalgia. Retrieved on June 15, 2010 from http://www.mayoclinic.com/health/fibromyalgia/DS00079.
National Fibromyalgia Association. (2009). Fibromyalgia. Retrieved on June 15, 2010 from http://www.fmaware.org/site/PageServer?pagename=fibromyalgia .
Testing for Fibromyalgia. (2010). Retrieved July 12, 2010, from Fibromyalgia Symptoms: http://www.fibromyalgia-symptoms.org/fibromyalgia_diagnosis.html.