Bridges and Pathways Institute Inc.

Fibromyalgia Syndrome and Australian Health and
Community Services

Bridges & Pathways Institute Foundation Southern Chronic Illness Links Network is working to improve services for Australians affected by Fibromyalgia Syndrome and associated conditions.

This work is in partnership with other agencies through the Australian Collaboration Project for Fibromyalgia Best Practice and Education
 
Fibromyalgia Syndrome (FMS) (see below Fibromyalgia Syndrome*) is an important condition in public health and community health programs because studies estimate that between 2% and 10% of the general population i.e. 65,000 South Australians have FMS. It is a common rheumatic condition that affects all ages including children, all nationalities, culture and socioeconomic groups. As in many painful conditions, such as arthritis, there is a higher prevalence of FMS in females. It is two to five times more common than rheumatoid arthritis.
 
Fibromyalgia Syndrome (FMS) and the Australian Healthcare System Australians living with FMS like those of all chronic illnesses are benefiting from the Australian health services reform initiatives to reduce the impact of chronic illness on individuals, their families and the community.

This National Chronic Disease Strategy (Dept. Of Health, 2005) endorsed by state Health Ministers in November 2005.
  "provides the overarching framework of national direction for improving chronic disease prevention and care across Australia". Piii

 
In the last ten years the Australian healthcare system has increasingly focused on the better management of chronic diseases through an integrated multidisciplinary primary healthcare management approach
(Dept H & A Website page). The Government is working together with patients, disease organisations and providers to promote good health and reduce the burden of chronic disease.
 
To complement these service reforms there are new and better funding arrangements through Medicare funding, the setting up of GP Plus Health Care Centres, Allied health team care arrangements, and the Australian Better Health Initiative.

The Australian Better Health Initiative includes the following priority areas:

  • promoting healthy lifestyles
  • supporting early detection of risk factors and chronic disease
  • supporting lifestyle and risk modification
  • encouraging active patient self management of chronic conditions
  • improving the communication and coordination between care services.
For people with Fibromyalgia, the Australian Collaboration Project for Fibromyalgia Best Practice & Education has been developing an illness specific National Action Plan Framework for Fibromyalgia.
The National Action Plan Framework for Fibromyalgia also has five key areas:
  • early intervention and diagnosis
  • prevention or minimising disability and losses
  • active management and continuity of care through the different stages of a person's life
  • maintaining lifestyle and positive health outcomes
  • better communication and partnerships with providers
These will be evaluated consistent with the priority areas of the National Chronic Disease Strategy and Australian Better Health Initiative.
Chronic Disease Self Management Imitative (2000-2005)
One of the core strategies of the National Chronic Disease Management Initiatives (Dept. Of Health Website) has been the rollout and evaluation of the Sharing Care / Stanford Chronic Disease Self Management Program (Arthritis South Australia).

In tandem with this, the Australian FMS Collaboration Project has been:
  1. monitoring the outcomes of people with FMS participating in these generic programs and developing **Fibromyalgia Specific Education add-on Modules for those affected by FMS. These programs are provided within a quality framework and are evaluated for changes in patient outcomes and key performance indicators.
  2. piloting ***integrated management and care plans (One to One) for clients, consistent with Australian General Practice Allied Health Medicare arrangements.
Feedback on Management, Information and Service Gaps
The Australian Collaboration Project for Fibromyalgia Best Practice and Education welcomes your feedback and suggestions so that we can all work together to provide up-to-date information to the Government, service providers, and researchers to improve the daily care of Australians living with Fibromyalgia. Contact fibromyalgia.australia@gmail.com or bpprojects@telstra.com.
       
Resources are available to help you and your provider from Fibromyalgia SA.
       
*Fibromyalgia Syndrome (FMS) is a complex and heterogeneous condition characterised by long standing widespread body pain without any obvious tissue damage. It involves abnormal pain processing, often with changes in pain threshold. For more information contact
bpprojects@telstra.com or fibromyalgia.australia@gmail.com.

Medically, FMS carries a fairly good prognosis. It does not cause joint deformity although the pain and discomfort of FMS can last for many years.

Optimal management of FMS starts with a comprehensive assessment and correct diagnosis. Early intervention (starting as soon as possible) and a tailored multidisciplinary patient centred approach to management are important to reduce disability, symptom severity and the total illness burden. Progress can be slow and should be maintained to achieve lasting benefits.

Each management program should be designed individually and can be coordinated at the General Practice level consistent with Australian Medicare GP Plus, Allied Health integrated care planning funding arrangements.
       
The Australian Collaboration Project for Fibromyalgia Best Practice & Education is using evidence based and strategic consensus documents to improve the care and management of people living with FMS.

These include the:
  • EULAR evidence based recommendations for the management of Fibromyalgia Syndrome Carville et al 2007
  • Fibromyalgia Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners An Overview of the Canadian Consensus Document Carruthers & van de Sande 2004, download pdf (FMS Canadian pdf ) or order form for Australian print edition (Word File enclosed)
  • Guidelines for the management of Fibromyalgia syndrome pain in adults and children Buckhardt et al National Guideline Clearinghouse AHRQ 2005
  • Fibromyalgia Chakrabarty & Zoorob 2007
  • Fibromyalgia treatment update Rooks 2007
These **Fibromyalgia Chronic Disease Self Management Modules (Group activities) are:
  run by:    
 
  • Peer leaders (people who live with the condition)
 
  using:    
 
  • Patient priorities
 
  Encouraging participants (people with Fibromyalgia) to:  
 
  • Learn about their condition using standardised Patient Education Sheets
  • Develop Personalised goals/outcomes
  • Use Personal action plans (decision making tools)
  Monitored and influenced by feedback and research from:  
 
  • Individual patients and Fibromyalgia support groups across Australia and their providers
  These programs are provided within a quality framework and are evaluated for changes in patient outcomes and key performance indicators.
***Individual integrated management and care plans (One to One)
  For patients with FMS optimal and effective management starts with a confirmation of a correct diagnosis (Tender points diagram). In clinical settings it is important to conduct a comprehensive assessment of the total illness burden (pain, function psychosocial) and list all the associated symptoms and signs. As the range and intensity of symptoms vary over time patients are encouraged to monitor their symptoms regularly and particularly during new treatment interventions. This facilitates better feedback to providers, informs decision making and helps recognise illness patterns/changes (stable or reactive phases).
A Fibromyalgia Management Care Plan will usually include:  
 
  • education
  • sleep and stress management
  • exercise and movement - gentle, patient specifc
  • pharmacological management - medication
  • outcome monitoring
  Your General Practitioner or GP Plus case worker can help you develop an integrated management program that accesses allied health services through the new Medicare funding arrangements.

For more information or to provide feedback please email fibromyalgia.australia@gmail.com or bpprojects@telstra.com

The Australian Collaboration Project for Fibromyalgia Best Practice and Education is an interagency project working to provide Australians with Current Best Practice Information Fibromyalgia Syndrome.
 
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