A diagnosis of fibromyalgia increases the risk of a serious traffic crash that continues for years after the initial diagnosis, according to a new study by researchers at the Institute for Clinical Evaluative Sciences (ICES).
Fibromyalgia is a common condition affecting more than 200,000 Canadian adults that disrupts nerve function and leads to chronic pain. Fibromyalgia is associated with widespread fluctuating symptoms such as muscle pain, fatigue, insomnia, and joint stiffness that can be treated by medications, lifestyle changes and stress management.
Past research has shown that fibromyalgia is sometimes a consequence of a past motor vehicle crash; however, this is the first study to investigate whether fibromyalgia could also lead to a future motor vehicle crash.
“We found the absolute risk of a serious motor vehicle crash for adults diagnosed with fibromyalgia approached the rate observed among other patients diagnosed with alcoholism,” said Dr. Donald Redelmeier, senior scientist at ICES and senior author of the study, now published online in The Journal of Rheumatology and slated for print publication next week.
The researchers estimate that the increased absolute risk equates to about a seven per cent annual chance of a traffic crash of some severity among drivers with fibromyalgia. Redelmeier cautions “this does not necessarily mean that patients are at-fault for the traffic crash; instead, it might be that fibromyalgia impairs a driver’s ability to avoid a crash caused by someone else.”
Motor vehicle crashes can be serious for patients with chronic medical conditions. The significant consequences provide the rationale for health prevention including warnings by physicians to patients regarding safe driving. Most crashes can be avoided with standard advice such as respecting the speed limit, stopping at stop signs and avoiding distractions.
The researchers studied 137,631 adults diagnosed with fibromyalgia between April 1, 2006 and March 31, 2012 in Ontario, of whom 738 had another crash in the first year following diagnosis. The crash rate was more than twice the population norm for both those with a new or a persistent diagnosis. The researchers defined a serious motor vehicle crash as incidents sending the driver to hospital.
“Our study shows that a diagnosis of fibromyalgia identifies individuals at ongoing risk of a serious traffic crash who might benefit from specific medical treatment to mitigate this risk,” said Redelmeier, who is also a staff physician at Sunnybrook Health Sciences Centre and a professor of medicine at the University of Toronto.
The researchers stress that the data do not prove that fibromyalgia caused the crashes because patients may differ in multiple ways from the population norm. Potential differences include comorbidities, use of psychotropic drugs and amounts of daily driving. Fibromyalgia might also impair a person’s ability to avoid a crash or impede a person’s ability to recover afterward.
The researchers add that that the study also suggests that the risk was partially mitigated for patients who received dedicated fibromyalgia care or a physician warning for driving safety.
“Fibromyalgia and the risk of a subsequent motor vehicle crash,” is currently available online in The Journal of Rheumatology and will be published in print next week.
Author block: Donald Redelmeier, Jeremy Zung, Deva Thiruchelvam and Robert Tibshirani.
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.
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