2 The Pain in Europe Research Largest survey ever undertaken into painPrevalence data based on >46,000 interviewsAttitudinal data from almost 5,000 interviewsStriking results demonstrate the devastating impact of chronic pain
3 ObjectivesEstimate the prevalence of chronic pain conditions across EuropeUnderstand and quantify the sources and causes of chronic pain;Explore the demographics of sufferers;Explore the impact of pain on sufferers’ quality of lifeUnderstand current treatment practices & levels of satisfactionExplore the attitudes of sufferers toward and experiences with pain
5 Methodology Determine the prevalence of chronic pain by country CATI (Computer Assisted Telephone Interviewing), random diallingScreener Questionnaire (2,900 average)Determine the prevalence of chronic pain by countryDetailed Questionnaire (300)Inclusion CriteriaAdult (18 years old or older);Suffered pain for at least 6 months durationHas experienced pain within the past monthExperienced pain at least several times a weekPain intensity >5/10Has not participated in medical studies.
9 Pain - A Widespread Problem Strikes almost one in five adults across Europe = 19% (75 million people)Prevalence highest in Norway, Poland and Italy (>one in four)Prevalence lowest in Spain, but still more than one in ten (11%)One-third of all European households are affected by chronic pain
10 Prevalence of Chronic Pain by Country – Based on Complete Screener Data –Overall Prevalence = % (n=46,394) Moderate 13% Severe 6%30%27%26%23%21%19%18%17%16%15%13%11%Norway (n=2,018)Germany (n=3,832)Poland (n=3,812)Israel (n=2,244)Italy (n=3,849)Denmark (n=2,169)Belgium (n=2,451)Switzerland (n=2,083)Austria (n=2,004)France (n=3,846)Finland (n=2,004)Ireland (n=2,722)Sweden (n=2,563)UK (n=3,800)Netherlands (n=3,197)Spain (n=3,801)SevereModerate
11 Patients Forced to Live in Pain On average, sufferers live with chronic pain for 7 yearsA fifth suffer with pain for more than 20 years%Duration of Pain Reported by Chronic Pain Sufferers (n=4,839)Source: SQ6. For how long have you suffered from pain due to your illness or medical condition?
12 How Often Does it Hurt?One third of sufferers report experiencing chronic pain all the timeFrequency(n=4,839)Source: SQ8. How often do you experience pain? (Read list) SQ7. When was the last time you experienced pain? (Read list)
14 Most Common Causes of Pain Reported by Chronic Pain Sufferers Where does it hurt?The most frequent cause of chronic pain is arthritis / osteoarthritis (34%)The most common location is the lower backMost Common Causes of Pain Reported by Chronic Pain Sufferers(n=4,292)%Source: SQ11. Where is your pain located? SQ12. Please tell me the illness or medical condition that is the cause of your pain. Q1. Is your pain caused by…?
15 Tolerance Level for More Pain And How Much?One third reported that their pain was so severe they could not tolerate any moreTolerance Level for More Pain(n=4,785)Source: Q4. Thinking about the intensity of your pain when it was at its worst, which of the following statements best describes your tolerance level of this pain?
17 Chronic Pain is Insidious Over 40% of sufferers report feelings of helplessness or inability to think or function normallyOne in six say the pain is sometimes so bad they want to die
18 Chronic Pain is Insidious %* Higher=Agree more strongly with the statementSource: Q37. Now we would like to understand how pain affects your life. I am going to read a list of statements that could be used to describe how people who are experiencing pain think and feel about it. For each statement I read, please think about yourself and your own pain and tell me how much you agree or disagree with each statement using a 5-point scale where 1=Disagree Completely, 2=Disagree Somewhat, 3=Neither Agree nor Disagree, 4=Agree Somewhat, and 5=Agree Completely. (Read list)
19 And Can Devastate Lives Chronic pain has an undoubted impact on the daily lives of sufferersChronic pain impacts on daily activities such as lifting, exercising, sleeping and working outsideOne quarter (26%) feel that their pain impacts employment15 working days a year are lost to pain (estimate on 6 month data)One in five reportslosing a job (19%)or have been diagnosed with depression as a result of their pain (21%)
20 And Can Devastate Lives Weighted TotalUK (n=243)France (n=232)Germany (n=232)Italy (n=233)Spain (n=255)Poland (n=220)Sweden (n=292)Norway (n=289)Denmark (n=298)Lost job19%25%15%14%17%22%24%29%Changed job responsibilities16%12%11%28%8%21%Changed jobs entirely13%18%20%4%Been diagnosed with depressionSource: Q6a. Have any of the following ever happened as a result of your pain…? (Read list) Q6b. Have you ever been diagnosed with depression by a medical doctor as a result of your pain?
21 And Can Devastate Lives Netherlands (n=294)Belgium (n=286)Finland (n=290)Ireland (n=272)Switzerland (n=274)Austria (n=279)Israel (n=299)Lost job29%15%22%16%20%25%Changed job responsibilitie s9%19%24%17%Changed jobs entirely14%23%12%11%Been diagnosed with depression18%21%
23 Patients See Different Clinicians But Rarely Pain Specialists Consultations were most frequently with GPsOrthopaedists and to a lesser degree Rheumatologists and Neurologists are also seenOnly 23% report seeing an actual pain specialist
24 Chronic Pain Patients See Many Different Clinicians Physician Specialty% Who SeeGeneral/Family PractitionerOrthopaedist/Orthopaedic SurgeonRheumatologistNeurologist//NeurosurgeonInternistPhysiotherapistGeneral SurgeonPain Management SpecialistOsteopathOther *When asked specifically whether ever been to a pain management specialist70%27%9%10%7%6%3%2%20%23%* Other includes Alternative Medicine/Homeopathy, Anesthaesiologist/Anesthaetist, Cardiologist, Chiropractor, Ear Nose Throat, Gastroenterologist, Gynecologist, Hematologist, Infectious Disease, Oncologist, Ophthalmologist, Physical Medicine, Plastic Surgeon, Psychiatrist, Pulmonoloigst, Radiologist, Sports Medicine, and Urologist.Source: Q12c. What kinds of doctors are you currently seeing specifically for your pain? Q12d. Have you ever been to see a pain management specialist?
25 Doctors DefendedThe majority (62%) are very or extremely satisfied with the doctor who treats their pain have seen them 1.3 times in last six months%* Higher = betterSource: Q14d. How satisfied are you with the doctor who currently treats your pain? (Read list) Q14e. Why do you say you are not very/not at all satisfied with the doctor who currently treats your pain?
26 But There are Still Problems Some patients worry about their doctor’s willingness and commitment to treating their painA sizeable proportion (43%) of chronic pain sufferers believe that their physicians are more focused on their illness than their painIn making a diagnosis or deciding on treatment, few doctors use pain rating scales (10%)Most discussions are patient initiated
27 But There are Still Problems %Source: Q37. disagree with each statement using a 5-point scale where 1=Disagree Completely, 2=Disagree Somewhat, 3=Neither Agree nor Disagree, 4=Agree Somewhat, and 5=Agree Completely. (Read list)Source: Q13c. How does the doctor who generally treats your pain determine how much pain you are in? Q14a. Has any doctor or medical professional ever scored you on a pain scale?
28 Feelings about Treatments Two thirds of sufferers are always willing to try new treatmentsBut almost as many are worried about potential side effects of pain medication
29 Feelings about Treatments %* Higher=Agree more strongly with the statementSource: Q37. Now we would like to understand how pain affects your life. I am going to read a list of statements that could be used to describe how people who are experiencing pain think and feel about it. For each statement I read, please think about yourself and your own pain and tell me how much you agree or disagree with each statement using a 5-point scale where 1=Disagree Completely, 2=Disagree Somewhat, 3=Neither Agree nor Disagree, 4=Agree Somewhat, and 5=Agree Completely. (Read list)
30 Use of Prescription Medicines Pain sufferers are proactive with 69% of chronic pain sufferers treating their pain in some way, mainly via prescription medicationsOver one in four (26%) have tried then stopped taking prescription pain medication
31 Use of Prescription Medicines Chronic Pain Sufferers ReportingCurrently Treating Their Pain in Any Way (n=4,827)Use of Prescription MedicationsTo Treat Chronic Pain(n=4,839)Source: Q11a. Is your pain currently being treated in any way? Q15a. Have you ever taken prescription medicine for your pain? Q16a. Are you currently taking prescription pain medicine?
32 Use of Prescription Medicines NSAIDs (44%) are most used class of pain medicationOther commonly prescribed drugs are weak opioids (23%) and paracetamol (18%)Mean number of pills taken everyday is 3.4
33 Use of Prescription Medicines %Weak OpioidsStrong OpioidsSource: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing?
34 Classes of Prescription Pain Medications Chronic Pain Sufferers Report Currently Using for Pain – European Summary – (n=2,063)Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing?
35 Weighted TotalUK (n=300)France (n=300)Germany (n=302)Italy (n=300)Spain (n=301)Poland (n=300)Sweden (n=300)Norway (n=304)Denmark (n=303)NSAIDs44%23%25%54%68%49%71%27%24%38%Weak Opioids50%19%20%9%13%28%36%8%Paracetamol18%2%6%26%45%0%COX-2 Inhibitors3%7%1%11%Strong Opioids5%12%4%Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing? (most common mentions)
36 Netherland s (n=300) Belgium (n=301) Finland (n=303) Ireland (n=300) Switzerland (n=300)Austria (n=303)Israel (n=322)NSAIDs36%42%54%32%48%58%53%Weak Opioids14%15%22%19%18%5%Paracetamol11%33%26%12%4%3%COX-2 Inhibitors16%13%8%Strong Opioids7%2%Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing? (most common mentions)
37 Use of Non- Prescription Medicines Non-Prescription (OTC) Classes and Medications Chronic Pain Sufferers Report Currently Using for Pain (n=1,914)Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing?
38 Alternative Therapies %Source: Q28. What other methods, remedies or treatments, apart from medications have you ever tried to relieve your pain for the medical condition or illness we have been discussing?
39 How Patients Rate Treatments The majority (64%) of pain sufferers feel their treatment is inadequate at timesChronic pain sufferers report that there is considerable room for improvement in the effectiveness of pain treatments
40 How Patients Rate Treatments Adequacy of Pain Control from Medication(n=2,450)Pain from Activity(n=4,787)Source: Q21. Do you ever experience an increase in pain during the day as a direct result of an activity you did? Q20. Are there ever times when your pain medicines are not adequate to control your pain?
41 Learning About New Pain Treatments Over one quarter of all chronic pain sufferers feel they never hear about new methods of treating painMajority rely on newspapers, TV and magazinesJust 5% surf the ‘Net for new optionsSource: Q36. Where do you hear about new methods for treating pain?
42 Learning About New Pain Treatments Where Chronic Pain Sufferers Report Hearing About New Pain Treatments (n=4,586)%Source: Q36. Where do you hear about new methods for treating pain?