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Title: Improving outcome for people with chronic widespread pain and fibromyalgia
Author: Macfarlane, Gary John
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 2021
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Chronic widespread pain is characteristic of fibromyalgia, a condition which also includes features such as cognitive dysfunction, sleep problems, fatigue and mood disorders. The lack of objective measures of the disorder has proved challenging in terms of diagnostic criteria, and thus timely diagnosis and access to effective management. Although there is a perception that the aetiology of the condition is not known and that there is no effective treatment, this is not the case. Over the past decades understanding of the pathophysiology and aetiology of the condition has improved and management that results in improved symptoms for many patients, has been identified. This thesis addresses important components in relation to improving outcome for patients with chronic widespread pain and fibromyalgia. The thesis focuses on three areas (over seven published manuscripts): effective management for persons with chronic widespread pain and fibromyalgia; investigating excess mortality in people with chronic widespread pain; Identifying and managing fibromyalgia when it occurs in the context of inflammatory arthritis. It includes seven manuscripts. The results of the manuscripts show that there is good evidence for the non-pharmacologic therapies of exercise and a cognitive behaviour informed approach to managing people with chronic widespread pain/fibromyalgia, that the excess mortality in such patients could be addressed by focussing on lifestyle factors (diet and exercise). When fibromyalgia occurs in the context of axial spondyloarthritis, such patients do (as a group) respond to biologic therapy but that specific aspects of their conditions (high somatic symptom burden) predict non-response and the likely need for additional (non-pharmacologic approaches) to management.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Sc.) Qualification Level: Doctoral
Keywords: R Medicine (General)