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The aim of this study was to compare clinical symptoms, perceived health status, health resource use and psychosocial features in fibromyalgia (FM) patients at different health care levels. A total of 315 participants were recruited from primary care (PC) (n = 101) and rheumatology settings (RS) (n = 214). Subjects completed a protocol of clinical features and health resource use, hospital anxiety and depression scale, sickness impact profile, chronic pain self-efficacy scale, multidimensional pain locus of control scale, perceived health competence scale and chronic pain coping inventory. Student’s t test, effect size, and contrast and power test were performed to examine differences between samples. FM patients treated in PC and RS were similar in most variables assessed and only differed significantly in tender points, sleep disturbance, wellness-focused coping strategies and in self-efficacy beliefs. The similarities do not support patient selection through care levels and thus, in the Spanish health care system at least, endorse PC as a reference unit for treatment and questioning the benefits of referring patients to RS.

This work identifies which psychosocial, clinical and perceived health status factors predict health-resource use in Fibromyalgia (FM), considering the patients' assistance level. Participants were 315 FM patients from Primary Care (PC: n=101) and Rheumatology Services (RS: n=214). Stepwise regression analysis showed that self-efficacy variables were significant predictors of medication intake in PC, and, along with Illness-focused coping, of the health service use. In RS, perceived health status was the best predictor of medication intake. In any case, Pain intensity significantly predicted the use of health resources. These data offer a new perspective for intervention in these patients, taking into account the level of assistance.