Surveys Of Pain In The Community

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There have been a number of recent market research studies of chronic pain. These employ telephone surveys administered to people in the community prescreened for chronic pain. The largest of these was the Survey of Chronic Pain in Europe funded by Mundipharma Inter-national.24 This study included interviews with 4839 individuals with chronic pain, about 300 per country, from 15 European countries and Israel. The purpose of the study was to estimate the prevalence of chronic pain, explore underlying features and correlations with demographic issues, to examine impact on quality of life and daily functioning, and understand individual attitudes. Overall they estimated that 19 percent of all those screened (N =46,394) had chronic pain for at least six months, including the last month, at least twice a week, and rated at least five out of ten on a numerical rating scale of pain severity. The median duration of pain was seven years.

Selected findings from the more than 36 tables and figures presented by Breivik et al.24 are shown in Figure 13.1. For example, of those with chronic pain surveyed,

40 percent reported they were less able to walk, 56 percent less able to sleep, and 21 percent were diagnosed with depression. Most respondents were seeking treatment for pain (69 percent) and taking prescription medications (52 percent). A few additional findings not included in Figure 13.1 were that 32 percent of respondents considered themselves no longer able to work outside the home and around 50 percent considered themselves less able to do lifting or exercising. Mean time lost from work in the previous six months was 7.8 days. In terms of healthcare use, 58 percent of respondents had seen two or more doctors related to their pain, and 30 percent felt that their doctor did not know how to control their pain. Only 2 percent were currently treated by a pain management specialist and the same percentage reported having sought therapy or counseling.

There are a series of additional studies conducted over the past several years, typically in the USA, that similarly highlight the experience of chronic pain, its impact on daily living, and some of the frustrations of the treatment experience. One of these, reported in April 2004, was conducted for the American Chronic Pain Association, sponsored by Endo Pharmaceuticals, and conducted by Roper Public Affairs and Media.25 It was a survey of 800 adults with chronic pain sampled from a process of random digit dialling. For the purpose of this study, chronic pain was defined as pain that occurs constantly or flares up frequently at least once per month, and not caused by cancer. Most of those surveyed (72 percent) had their pain for more than three years. The impacts on daily living were remarkably similar to those from the European survey: interference with daily routines (61 percent), household chores (67 percent), or sleep (78 percent); adverse effects on relationship with partner (28 percent), decreased productivity at work (51 percent), depression (46 percent), or feeling unable to cope (35 percent). Concerns about side effects of medications were common (56 percent), and nearly half of respondents reported that their pain was not under control (47 percent).

The findings from the surveys described here have been essentially duplicated many times using similar telephone survey-based approaches (see, for example, Ref. 26). Limitations of this method are important to take into account. The results obtained from these methods clearly represent the personal views of the respondents. These include complex judgments and are likely shaped by the survey methods used. They are, however, a unique perspective on pain sufferers outside a clinical situation.

Less able to walk Less able in household Less able socially Less independent Less able in work Less able to sleep Impaired concentration Diagnosed depressed Feeling helpless Feeling disbelieved Feeling alone with pain Taking prescribed meds Worry about side effects Not satisfied with treatment

40

42

21

0 10 20 30

40 50 60 % Respondents

70 80 90 100

Figure 13.1 Selected results from Breivik et al.'s 2006 survey of individuals with chronic pain covering 15 European countries and Israel (n = 4839).24

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