FIBROMYALGIE: Bientôt reconnue comme Affection de Longue Durée (ALD)? – Assemblée Nationale

It was at the request of Member of the Oise, Patrick Carvalho, a 30-member Commission of Inquiry on fibromyalgia, conditions for its recognition and its management, has just been launched. It is estimated that the disease characterized especially by chronic debilitating muscle pain, affects 14 million Europeans and between 1.5 and 2 million French. Recognized as a “disease” by the World Health Organization (WHO) since 1992 and considered disease “impaired” in Belgium, fibromyalgia is however still not coded in the official index of conditions in the European Union. Today in France, patients undergo one second penalty, the lack of support. This is the result of the steps taken by the member: better meet our health system, suffering and the plight of hundreds of thousands of French fibromyalgia.

Image result for Patient

 Notably characterized by widespread pain, fibromyalgia is a chronic, systemic and multimodal disease that seems to affect both the central nervous system and the “small nerve fibers”  . A chronic musculoskeletal syndrome that does not affect less than 2% to 5% of the population, according to the latest estimates. This pain syndrome is associated with a now chronic fatigue , sleep disorders, irritable bowel syndrome, headaches, etc … making it a complex and often debilitating disease. The disease mainly affects women, with a sex ratio of 9: 1. Previous studies have already suggested, in addition to pain sensitivity, reduced tolerance to sensory stimuli and hypersensitivity to non-painful events .

 

The affections of long term exonérantes are defined in the Code of Social Security as disease whose severity and / or chronic, requires prolonged treatment and particularly costly therapy, and for which user fees are removed.

 

 ”  France, for its part, continues to consider fibromyalgia as a syndrome .

 

Many parliamentarians have questioned the government over the years on the subject and have always got the same answer, that of a status quo.

It is considered that this syndrome has no known cause. Its diagnosis is made by default with other diseases identification. There is no specific treatment, including medication, or well-established support.

 

This has consequences for patients .

– They are first delivered to a medical wandering.

– They do not know which doctor to turn: rheumatologist, psychologist, neurologist …

– The time that elapses between the first symptoms and the final diagnosis is on average six years. Six long years without knowing what the patient has no prospect.

– Therefore, loneliness sets in and the ills of the body invade the mind, adding to the physical pain of depressive symptoms.

 

Regarding treatment, prescriptions tend to try to stem the symptoms with the use of pain killers, antidepressants, anticonvulsants often accompanied by side effects completing the initial pain without addressing them.

Other therapies, non-drug, are used (physiotherapy, therapy, psychotherapy, relaxation, acupuncture).

 

The medical profession is, moreover, little training in this type of disease chronic. Some practitioners are still skeptical of the nature of fibromyalgia, considering it as a psychological disease, which has implications for the quality and effectiveness of prescribed treatments. To this is compounded by conflicting relations with the administrations (CPAM, departmental homes for disabled persons, occupational medicine …), since the diagnosis is established by default to other pathologies and recognition that Social Security does not recognize not fibromyalgia as a disease. Fibromyalgia via the CIM code 10 M 79.7, is also not present in the database of the CPAM.

It follows the non-recognition of a disability caused by this disease, not supported by “long-term condition” (ALD), or ALD 31 for an unaccompanied fibromyalgia other diseases, breaking the payment of daily allowances for a stop prolonged illness due to fibromyalgia “.

 

Scientific expertise is yet available:

– The National Academy of Medicine published a report in January 2007, stating: “a broad consensus exists yet today to consider that […] the fibromyalgia syndrome is a clinical reality that must be recognized as autonomous, once eliminated other conditions that can be a chronic pain syndrome “.

– The National Health Authority issued a policy report in January 2010, concluded: “Although controversy remains even within the medical world, sometimes on the existence, but especially on organic or functional causes of this syndrome, a care should be accessible to patients. The lack of support, scientifically validated and consensus, should not lead to leave patients without response and professional no solution to offer “.

– Inserm has been commissioned to undertake a comprehensive study on fibromyalgia in adults and in children.

So it is now appropriate response to this public health problem.

 

Sources:

National Assembly 29 February 2016   Proposal for a resolution by Mr Patrice Carvalho and others to create a commission of inquiry on fibromyalgia, No. 3518, filed February 18, 2016

 

Article D. 322-1 of the Code of Social Security, as amended by the decrees n ° 2004-1049 of 4 October 2004, OJ October 5, 2004 and No. 2011-77 of 19 January 2011 published in the Official Gazette of January 21, 2011 list of ALD

Add a Comment

Your email address will not be published. Required fields are marked *