A crucial step towards improving the care of people with fibromyalgia is understanding current practice. Our systematic review aims to address this by synthesising the global evidence around healthcare use in people with fibromyalgia, including its variation across groups of people, geographical locations, and over time.

Fibromyalgia is a chronic condition characterized by widespread pain alongside a broad range of non-pain symptoms. Its substantial impact on peoples’ lives and high prevalence mean that ensuring people with fibromyalgia receive evidence-based and appropriate care is a clinical and research priority. Whilst guidelines recommend that people with fibromyalgia receive a prompt diagnosis, care that focuses on non-pharmacological interventions, and in many countries should be predominantly managed in the community, existing evidence indicates they often wait many years for a diagnosis, commonly receive long-term opioid medicines, and see multiple hospital specialists.

Relevant databases will be searched, with 25% of screening, data extraction, and quality appraisal conducted by two reviewers. Eligible studies will have evaluated healthcare use in adults with fibromyalgia using data obtained from electronic health record, registry, or insurance databases (providing generalizable findings in large, representative datasets). Data will be synthesized using meta-analysis and/or synthesis without meta-analysis where possible.

By providing an in-depth analysis of healthcare use and its variation in people with fibromyalgia, the results from this systematic review could be used to benchmark practice, inform targeted management strategies to those with the highest levels of healthcare use (and therefore care need), and provide insight into whether certain countries require specific guideline/policy changes.

Electronic medical record (EMR) systems in primary care present an opportunity to address frailty, a significant health concern for older adults. Researchers in the UK used Read codes to develop a 36-factor electronic frailty index (eFI), which produces frailty scores for patients in primary care settings.

We aimed to translate the 36-factor eFI to a Canadian context.

We used manual and automatic mapping to develop a coding set based on standardized terminologies used in Canada to reflect the 36 factors of the eFI. Manual mapping was completed independently by two coders, followed by group consensus among the research team. Automatic mapping was completed using Apelon TermWorks. We then used EMR data from the British Columbia Canadian Primary Care Sentinel Surveillance Network. We searched structured data fields related to diagnoses and reasons for patient visits to develop a list of free text terms associated with any of the 36 factors.

A total of 3768 terms were identified; 3021 were codes. A total of 747 free text terms were identified from 527,521 reviewed data entries. Of the 36 frailty factors, 24 were captured mostly by codes; 7 mostly by free text; and 4 approximately equally by codes and free text. Three key findings emerged from this study: (1) It is difficult to capture frailty using only standardized terminologies currently used in Canada and a combination of standardized codes and free text terms better captures the complexity of frailty; (2) EMRs in primary care can be better optimized; (3) Output from this study allows for the development of a frailty screening algorithm that could be implemented in primary care settings to improve individual and system level outcomes related to frailty.