Juvenile fibromyalgia syndrome and improved recognition by pediatric primary care providers
Insights
Juvenile fibromyalgia syndrome (JFS) is a chronic pain condition in children. A new screening tool and provider education improved JFS recognition and reduced diagnostic delays in pediatric patients.
Area of Science:
- Pediatric rheumatology
- Medical diagnostics
Background:
- Juvenile fibromyalgia syndrome (JFS) causes widespread pain in children, impacting quality of life and leading to anxiety or depression.
- Delayed diagnosis of JFS is common due to primary care providers' unfamiliarity with the condition.
Purpose of the Study:
- To evaluate the effectiveness of a developed screening tool, the SORE Scoresheet, in improving the recognition of JFS in pediatric patients.
- To assess the impact of provider education on the timely diagnosis of JFS.
Main Methods:
- Implementation of the SORE Scoresheet screening tool in a pediatric clinic from September 2011 to January 2012.
- Education of pediatric providers on the use of the SORE Scoresheet prior to project initiation.
Main Results:
- Twenty-two patients with JFS were successfully referred using the SORE Scoresheet.
- A 93% symptom match rate was observed between pediatric providers and a rheumatologist.
- Significant reductions in referral time (weeks) and pre-referral visits were noted compared to 2010 data.
Conclusions:
- Provider education and the SORE Scoresheet screening tool are effective in enhancing the recognition of JFS in pediatric primary care.
- The study demonstrates a successful strategy for earlier diagnosis and intervention for pediatric patients with JFS.
Introduction:
Juvenile fibromyalgia syndrome (JFS) is a medically unexplained illness that can cause persistent, diffuse pain in a child or adolescent. This pain can lead to anxiety or depression and absence from school or work, and it can adversely affect a child's quality of life and family relationships. Prompt recognition of JFS may decrease problems for pediatric patients with chronic pain, but pediatric primary care providers' lack of familiarity with JFS can cause a delay in diagnosis.
Method:
A project using a developed screening tool, the SORE Scoresheet, was implemented in the pediatric clinic at Kaiser Permanente Fontana from September 2011 to January 2012. Pediatric providers were educated about the tool before the project began.
Results:
Twenty-two patients with JFS were referred with use of the SORE Scoresheet. Symptoms of JFS matched at a rate of 93% between the providers and the rheumatologist, and a reduction in the number of weeks to referral and the number of visits before referral was found compared with a sample of patients with JFS from 2010.
Conclusion:
Pediatric provider education and development of a screening tool assists with the recognition of JFS.
Related Concept Videos
01:20Myasthenia Gravis: Overview and Treatment
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which leads...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:22Myasthenia Gravis ll: Pathophysiology
01:26Nephrotic Syndrome II : Assessment and Medical Management
01:15Myasthenia Gravis: Diagnostic Tests
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...