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Extended report
Real-life assessment of the validity of patient global impression of change in fibromyalgia
  1. Emmanouil Rampakakis1,
  2. Peter A Ste-Marie2,
  3. John S Sampalis1,3,
  4. Angeliki Karellis1,4,
  5. Yoram Shir2 and
  6. Mary-Ann Fitzcharles2,5
  1. 1JSS Medical Research, St-Laurent, Quebec, Canada
  2. 2Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Quebec, Canada
  3. 3Department of Surgical Research, Jewish General Hospital, Montreal, Quebec, Canada
  4. 4Department of Surgery, McGill University, Montreal, Quebec, Canada
  5. 5Department of Rheumatology, McGill University Health Centre, Montreal, Quebec, Canada
  1. Correspondence to Dr Emmanouil Rampakakis; erampakakis{at}jssresearch.com

Abstract

Objectives Patient Global Rating of Change (GRC) scales are commonly used in routine clinical care given their ease of use, availability and short completion time. This analysis aimed at assessing the validity of Patient Global Impression of Change (PGIC), a GRC scale commonly used in fibromyalgia, in a Canadian real-life setting.

Methods 167 fibromyalgia patients with available PGIC data were recruited in 2005–2013 from a Canadian tertiary-care multidisciplinary clinic. In addition to PGIC, disease severity was assessed with: pain visual analogue scale (VAS); Patient Global Assessment (PGA); Fibromyalgia Impact Questionnaire (FIQ); Health Assessment Questionnaire (HAQ); McGill Pain Questionnaire; body map. Multivariate linear regression assessed the PGIC relationship with disease parameter improvement while adjusting for follow-up duration and baseline parameter levels. The Spearman's rank coefficient assessed parameter correlation.

Results Higher PGIC scores were significantly (p<0.001) associated with greater improvement in pain, PGA, FIQ, HAQ and the body map. A statistically significant moderate positive correlation was observed between PGIC and FIQ improvement (r=0.423; p<0.001); correlation with all remaining disease severity measures was weak. Regression analysis confirmed a significant (p<0.001) positive association between improvement in all disease severity measures and PGIC. Baseline disease severity and follow-up duration were identified as significant independent predictors of PGIC rating.

Conclusions Despite that only a weak correlation was identified between PGIC and standard fibromyalgia outcomes improvement, in the absence of objective outcomes, PGIC remains a clinically relevant tool to assess perceived impact of disease management. However, our analysis suggests that outcome measures data should not be considered in isolation but, within the global clinical context.

  • Fibromyalgis/Pain Syndromes
  • Patient perspective
  • Disease Activity

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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