Sociodemographic Factors, but Not Rurality, Explain Limited Variance in Fibromyalgia Severity: A Secondary Analysis of Two Randomized Clinical Trials

Ezgi Yarasir Gillette; Kari G Vance; Emine O Bayman; Dana L Dailey; Carol G T Vance; Ruth L Chimenti; Leslie J Crofford; Barbara J Van Gorp; Elizabeth M Johnson; Kristin R Archer; Heather Schacht Reisinger; Miriam Bridget Zimmerman; Kathleen A Sluka; Giovanni Berardi

doi:10.1093/pm/pnag088

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Sociodemographic Factors, but Not Rurality, Explain Limited Variance in Fibromyalgia Severity: A Secondary Analysis of Two Randomized Clinical Trials

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Sociodemographic Factors, but Not Rurality, Explain Limited Variance in Fibromyalgia Severity: A Secondary Analysis of Two Randomized Clinical Trials

Ezgi Yarasir Gillette, Kari G Vance, Emine O Bayman, Dana L Dailey, Carol G T Vance, Ruth L Chimenti, Leslie J Crofford, Barbara J Van Gorp, Elizabeth M Johnson, Kristin R Archer, …

Pain medicine (Malden, Mass.)

07/11/2026

DOI: 10.1093/pm/pnag088

PMID: 42434958

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Abstract

Fibromyalgia is characterized by a broad spectrum of symptoms such as pain, fatigue, and psychosocial impairments that collectively contribute to disease severity. This study aims to investigate the influence of living in rural versus urban settings on fibromyalgia severity. This is a secondary analysis of baseline data from 685 participants combined from two clinical trials. Survey data collected at baseline included sociodemographic characteristics (sex, age, rurality, race, ethnicity, income, education, employment status), pain and pain interference, fatigue, pain catastrophizing, and the Fibromyalgia Impact Questionnaire-Revised (FIQR). Study participants were 50.6±14.2 years, 96% female, and 44% resided in rural areas. FIQR was significantly associated with age (F = 5.511, p < 0.001), race (t=-3.628, p < 0.001), marital status (t = 3.410, p < 0.001), education status (F = 5.887, p = 0.003), employment status (t=-3.153, p = 0.002), and income (F = 13.147, p < 0.001) but not rurality (t=-0.350, p = 0.726). Cluster analysis based on rurality and sociodemographic variables resulted in two groups that differed by age, race, employment status, and income; FIQR was higher among those who were older, non-White, unemployed and with lower income. Using linear regression, sociodemographic variables contributed less than 10% of the variance in disease severity as measured by FIQR (R2=0.09) while rurality did not contribute. Additionally, sociodemographic variables contributed minimally to pain severity (9%) and interference (8%), widespread pain (4%), fatigue (6%), and pain catastrophizing (12%). Rurality and sociodemographic characteristics had limited influence on pain, fatigue, and pain catastrophizing, suggesting that fibromyalgia disease severity is minimally influenced by sociodemographic variables and not by rurality.

Fibromyalgia

Pain

fatigue

catastrophizing

Rurality

UIOWA OA Agreement

Details

Title: Subtitle: Sociodemographic Factors, but Not Rurality, Explain Limited Variance in Fibromyalgia Severity: A Secondary Analysis of Two Randomized Clinical Trials
Creators: Ezgi Yarasir Gillette - University of Iowa, Physical Therapy and Rehabilitation Science
Kari G Vance - University of Iowa, Physical Therapy and Rehabilitation Science
Emine O Bayman - University of Iowa, Biostatistics
Dana L Dailey - University of Iowa, Physical Therapy and Rehabilitation Science
Carol G T Vance - University of Iowa, Physical Therapy and Rehabilitation Science
Ruth L Chimenti - University of Iowa
Leslie J Crofford - University of Iowa, Physical Therapy and Rehabilitation Science
Barbara J Van Gorp - University of Iowa
Elizabeth M Johnson - University of Iowa, Physical Therapy and Rehabilitation Science
Kristin R Archer - Vanderbilt University Medical Center
Heather Schacht Reisinger - University of Iowa, Internal Medicine
Miriam Bridget Zimmerman - University of Iowa
Kathleen A Sluka - University of Iowa, Iowa Neuroscience Institute
Giovanni Berardi - University of Iowa, Physical Therapy and Rehabilitation Science
Resource Type: Journal article
Publication Details: Pain medicine (Malden, Mass.)
DOI: 10.1093/pm/pnag088
PMID: 42434958
NLM abbreviation: Pain Med
ISSN: 1526-4637
eISSN: 1526-4637
Publisher: Oxford University Press; OXFORD
Grant note: National Institutes of Health: UH3AR076387, UM1AR063381, UM1TR004403
This work was supported by the National Institutes of Health (UH3AR076387, UM1AR063381, UM1TR004403).
Language: English
Electronic publication date: 07/11/2026
Academic Unit: Iowa Neuroscience Institute; Biostatistics; Nursing; Center for Social Science Innovation; Anesthesia; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology; Internal Medicine
Record Identifier: 9985182816202771

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