Characteristics of elderly patients with fibromyalgia: a pilot retrospective study

Background and aims: Very little informations are available about the characteristics of fibromyalgia (FM) in older patients. The objective of the study was to know better what are some of their specificities in order to tailor the management of elderly patients with FM. Methods: Retrospective chart review of all patients with a diagnosis of FM addressed to the pain consultation of a geriatric hospital, have been analysed. Results: Forty patients (38 women and 2 men) were included. Mean age at the moment of diagnosis of FM was 75±9.1 years. Patients were hospitalized with a mean of 6±5.2 years after onset of FM. Median pain intensity measured by a visual or numerical pain scale was 6 at rest and 9 during mobilisation. Seventeen patients were isolated at home because of pain. Symptoms associated with FM were depression (n=25), fatigue and poor sleep quality (n=24), anxiety (n=15), irritable bowel syndrome (n=10), restless leg syndrome (n=3) and tension-type headache (n=2). Traumatic events, such as the death of a relative or nursing home admission were frequent. Twenty-four patients were discharged home, 13 patients in a nursing home and 3 patients died during the hospitalisation. Discussion: Although elderly patients with FM constituted a small proportion of elderly patient's addressed to a pain consultation, these patients have some particular features that must be taken into account. Further prospective studies should be conducted in this populatio

A European research agenda for somatic symptom disorders, bodily distress disorders, and functional disorders: Results of an estimate-talk-estimate delphi expert study

Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe

Transfert de patients entre deux services hospitaliers: information des patients

In order to determine what inpatients transferred to another inpatient care facility know about their health problems, the motives for their transfer, and the level of agreement between patients and physicians on these issues, we conducted a semi-structured interview and a content analysis of the transfer letter of 64 consecutive patients transferred from an academic internal medicine unit to a related intermediate care internal medicine unit with a vocation of rehabilitation and psychosocial care. After a mean length of stay of 18.5 +/- 11 days, 31% of patients did not know their medical diagnosis and only 54% knew at least one motive of transfer they agreed with. Only 48.5% of patients described a motive of transfer which was also found in their transfer letter. Doctors and patients disagreed on a psychosocial motive for transfer for 15.5% of patients. 14% of patients were opposed to their transfer and 7% did not know why they were transfered. Finally 22% of transfer letters were not informative enough to allow comparison. We conclude that at the time of their transfer a large number of patients lack adequate information on their diagnosis and on the reasons for their transfer