Juvenile Fibromyalgia Syndrome and Improved Recognition by Pediatric Primary Care Providers

Judith D. McLeod, DNP, RN, CPNP

Disclosures

J Pediatr Health Care. 2014;28(2):e9-e18. 

In This Article

Abstract and Introduction

Abstract

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.

Introduction

The increase in cost of medical care has become an issue in health care today. Prompt diagnosis and treatment of a patient's condition has become increasingly important to lessen the physical, emotional, and financial burden to the patient and family. Medically unexplained illnesses and conditions are difficult to identify, and the diagnosis for these disorders may be elusive. Inability to confirm a diagnosis because of lack of diagnostic tools or tests may lead to multiple visits with increasing expense and frustration for the patient and family. Improving recognition of a medically unexplained condition is important for improving the care of children with these conditions.

Juvenile fibromyalgia syndrome (JFS) is a medically unexplained illness that can cause persistent diffuse pain in children and adolescents. This pain may 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 (Kashikar-Zuck, Johnston, et al., 2010). Prompt recognition of JFS helps to decrease problems for these patients, but pediatric primary care providers' lack of familiarity with JFS may cause a delay in diagnosis.

The purpose of the project was to facilitate the recognition of JFS by primary care providers in the pediatric clinical setting.

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