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\begin{document}

\title{Utilization of Healthcare Services and Drug Consumption in Fibromyalgia:
A Cross-Sectional Analysis of the Clalit Health Service Database}



\author[1]{Omer Gendelman}%
\author[2]{Raz Shapira}%
\author[3]{Shmuel Tiosano}%
\author[4]{Yuval Kuntzman}%
\author[4]{Avishai Tsur}%
\author[4]{Aliza Hakimian}%
\author[5]{doron Comaneshter}%
\author[5]{Arnon Cohen}%
\author[6]{Dan Buskila}%
\author[1]{Howard Amital}%
\affil[1]{Affiliation not available}%
\affil[2]{Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel}%
\affil[3]{Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, Israel }%
\affil[4]{Tel Aviv University Sackler Faculty of Medicine}%
\affil[5]{Clalit Health Services Tel Aviv}%
\affil[6]{Ben-Gurion University of the Negev}%


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  \date{May 23, 2024}


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\begin{abstract}
Abstract Aim: To investigate the health care utilization and drug
consumption of patients with fibromyalgia (FM). Materials and Methods:
This is a cross-sectional study using the Clalit Health Care database.
Clalit is the largest HMO in Israel, serving more than 4.4 million
enrollees. We identified FM patients and age and sex-matched controls.
Indicators of healthcare utilization and drug consumption were extracted
and analyzed for both groups. Results: The study included 14,296 FM
patients and 71,324 controls. The mean age was 56 years, with a female
predominance of 92\%. The mean number of visits across of all healthcare
services (hospitalizations, emergency department visit, general
practitioner clinic visits, rheumatology clinic visits and pain clinic
visits) and the mean difference (MD) were significantly higher for FM
patients compared to controls (MD 0.66, p\textless{}0.001; MD 0.23,
p\textless{}0.001; MD 7.49, p\textless{}0.001; MD 0.31,
p\textless{}0.001; MD 0.13, p\textless{}0.001), respectively. Drug use
was significantly and consistently higher among FM patients compared to
controls; NSAIDs (non-steroidal anti-inflammatory drugs) OR 2.56,
P\textless{}0.001; Opioids OR 4.23, P\textless{}0.001; TCA (tricyclic
antidepressants) OR 8.21, P\textless{}0.001; Gabapentinoids OR 6.31,
P\textless{}0.001; SSRI (selective serotonin reuptake inhibitors) OR
2.07, P\textless{}0.001; SNRI (serotonin-norepinephrine reuptake
inhibitor) OR 7.43, P\textless{}0.001. Conclusion: Healthcare
utilization and drug use are substantially higher among patients with
fibromyalgia compared to controls%
\end{abstract}%



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