Fibromyalgia Health Outcome Study on Cost of Treatments (REFLECTIONS)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Eli Lilly and Company
ClinicalTrials.gov Identifier:
NCT00725101
First received: July 28, 2008
Last updated: November 29, 2012
Last verified: April 2012
  Purpose

The Real World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments (REFLECTIONS) Study is a 12-month, prospective observational study that will be utilized in approximately 58 care settings in the United States (US) and Puerto Rico. It is designed to examine treatment patterns and health outcomes of adult participants diagnosed by their physician with fibromyalgia (FM) and who are starting any "new pharmacologic agent" for FM.

The primary benefit of this study is enhanced understanding of the disease state of FM and the role that pharmacologic treatment plays, which may help to optimize management of FM. This study will address current gaps in a rapidly growing body of literature on FM.


Condition Intervention
Fibromyalgia
Drug: Treatment for Fibromyalgia

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Real World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments (The REFLECTIONS Study)

Resource links provided by NLM:


Further study details as provided by Eli Lilly and Company:

Primary Outcome Measures:
  • Cumulative Number of Medications Taken for Fibromyalgia (FM) Over 12 Months [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
  • Odds Ratio From Stepwise Logistic Regression Model of Baseline Medication Use for Fibromyalgia (FM): Duloxetine, Pregabalin, or Milnacipran Versus Any Other Medication [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Significant variables included in the final model were age over 65, physician gender and specialty, use of opioids (excluding tramadol), use of non-steroidal anti-inflammatory drugs (NSAIDs), and number of medications.

  • Odds Ratios From Stepwise Logistic Regression Model of Longitudinal Adherence to Duloxetine Treatment for Fibromyalgia (FM) Over 12 Months: Generalized Anxiety Disorder-7 (GAD-7) Score, Pregabalin Use, and Non-Steroidal Anti-Inflammatory Drug (NSAID) Use [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Significant variables included in the final model were pregabalin use, NSAID use, and GAD-7 (7-item, self-reported measurement of GAD severity [not at all severe, severe for several days, severe for more than half the days, severe nearly every day]; Total score=sum of all 7 items; ranges from 0 to 21; Higher score=greater level of anxiety). Odds ratios were based on medication possession ratio (MPR) ≥0.8 for pregabalin and NSAID use among duloxetine initiators at Baseline; MPR=total supply days/total number of days in 12-month study period.


Secondary Outcome Measures:
  • Reasons for Discontinuing Medications for Fibromyalgia (FM) During the Study [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Participants were allowed to select multiple reasons for discontinuing treatment. During the 12-month period post-baseline, a participant could possibly discontinue more than 1 medication, or discontinue the same medication more than once. A reason for discontinuation was given each time a participant stopped taking a medication.

  • Percentage of Participants Who Discontinued Opioids [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
  • Hazard Ratios for Factors Associated With Discontinued Opioid Use [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Factors significantly associated with discontinuation of opioid use were participant age, Brief Pain Inventory-Interference (BPI-I) score, and Patient Health Questionnaire for somatic symptoms (PHQ-15) score.

  • Change From Baseline in Brief Pain Inventory-Interference (BPI-I) Average Subscale Score at 12 Months [ Time Frame: Baseline, 12 months ] [ Designated as safety issue: No ]
    Average BPI-I measures self-reported degree of pain interference on function. Interference scores range from 0 (does not interfere) to 10 (completely interferes) for each question assessing interference of pain within past 24 hours for general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life. Average interference = average of non-missing scores of individual interference items.

  • Change From Baseline in Brief Pain Inventory-Severity (BPI-S) Average Subscale Score at 12 Months [ Time Frame: Baseline, 12 months ] [ Designated as safety issue: No ]
    BPI-S measures self-reported severity of pain. Severity scores range from 0 (no pain) to 10 (severe pain) for each question assessing worst pain, least pain, and average pain in past 24 hours, and current pain.

  • Change From Baseline in Fibromyalgia Impact Questionnaire (FIQ) Total Score at 12 Months [ Time Frame: Baseline, 12 months ] [ Designated as safety issue: No ]
    FIQ measures self-reported fibromyalgia (FM) status, progress, and outcomes over past week. FIQ comprises 20 items: Items 1-11 measure physical functioning (each rated on 4-point Likert-type scale); Items 12 + 13 measure number (no.) of days participant felt well and no. of days participant felt unable to work due to FM symptoms. Items 14-20 are numerical, 11-point Likert-type scales (marked in 10-millimeter [mm] increments) rating work difficulty, pain intensity, fatigue, morning tiredness, stiffness, anxiety, and depression. Total scores range from 0-80; Higher score=greater negative impact.

  • Change From Baseline in Sheehan Disability Score (SDS) Total Score at 12 Months [ Time Frame: Baseline, 12 months ] [ Designated as safety issue: No ]
    The SDS is completed by the participant and assesses the effect of the participant's symptoms on work/social/family life. Total scores range from 0 to 30; Higher score=greater disruption in the participant's work/social/family life.

  • Number of Outpatient Visits Due to Fibromyalgia (FM) [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
  • Number of Emergency Room (ER) Visits Due to Fibromyalgia (FM) [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
  • Number of Days of Partial Care for Fibromyalgia (FM) Participants [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Partial (day or night) care included day care, day nursing home, and partial hospitalization.

  • Number of Days of Caregiver Burden Due to Fibromyalgia (FM; Family Missed Paid Work and Used a Paid Caregiver) [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Caregiver burden was described as the number of days family members missed paid work and used a paid caregiver (for example, home healthcare nurse) to care for the participant with FM.

  • Number of Days of Caregiver Burden Due to Fibromyalgia (FM; Family Used an Unpaid Caregiver) [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Caregiver burden was described as the number of days family members used an unpaid caregiver (family and friends) to care for the participant with FM.

  • Number of Days Fibromyalgia (FM) Affected Participant Productivity (Stayed in Bed, Reduced Activity, and Received Disability Income) [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Participant productivity was described as the number of days the participant stayed in bed, had to reduce normal activity by half, and received disability income due to FM.

  • Number of Days Fibromyalgia (FM) Affected Participant Productivity (Missed Work) [ Time Frame: Baseline through 12 months ] [ Designated as safety issue: No ]
    Participant productivity was described as the number of days a participant missed work due to FM.


Enrollment: 1700
Study Start Date: June 2008
Study Completion Date: April 2011
Primary Completion Date: April 2011 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
Fibromyalgia (FM) Participants
FM participants starting any new pharmacologic FM agent.
Drug: Treatment for Fibromyalgia
FM participants starting any new pharmacologic FM agent.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Multiple care centers

Criteria

Inclusion Criteria:

  • Meet criteria for fibromyalgia (FM) in the opinion of the investigator
  • Must be prescribed a 'new' treatment for FM
  • Male and female participants at least 18 years of age
  • Willing to complete the Informed Consent Document (ICD) and any other required forms to be eligible for study participation
  • Currently under the care of the participating physician
  • Cognitively able to understand and complete participant self-rated scales in English or Spanish via computer-assisted telephone interview (CATI)
  • Available for 12 months to participate in the study

Exclusion Criteria:

  • Are investigator site personnel directly affiliated with the study and/or their immediate families. Immediate family is defined as a spouse, parent, child, or sibling, whether biological or legally adopted
  • Are Lilly employees
  • Are Terminally ill
  • Currently participating in other research studies or if beginning a research study while participating in this study
  • Unable to respond via telephone for CATI
  • Incompetent for interview as deemed by the participating physician
  • Unwilling to provide written ICD or other required forms to participate in the study
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00725101

  Show 58 Study Locations
Sponsors and Collaborators
Eli Lilly and Company
Investigators
Study Director: Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST) Eli Lilly and Company
  More Information

Additional Information:
No publications provided

Responsible Party: Eli Lilly and Company
ClinicalTrials.gov Identifier: NCT00725101     History of Changes
Other Study ID Numbers: 11540, F1J-MC-B020
Study First Received: July 28, 2008
Results First Received: April 27, 2012
Last Updated: November 29, 2012
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Fibromyalgia
Myofascial Pain Syndromes
Muscular Diseases
Musculoskeletal Diseases
Rheumatic Diseases
Neuromuscular Diseases
Nervous System Diseases

ClinicalTrials.gov processed this record on July 22, 2014