1. Pain in Europe Survey Pan-European Results

2. The Pain in Europe Research
Largest survey ever undertaken into pain
Prevalence data based on >46,000 interviews
Attitudinal data from almost 5,000 interviews
Striking results demonstrate the devastating impact of chronic pain

3. Objectives
Estimate the prevalence of chronic pain conditions across Europe
Understand and quantify the sources and causes of chronic pain;
Explore the demographics of sufferers;
Explore the impact of pain on sufferers’ quality of life
Understand current treatment practices & levels of satisfaction
Explore the attitudes of sufferers toward and experiences with pain

4. Methodology

5. Methodology Determine the prevalence of chronic pain by country
CATI (Computer Assisted Telephone Interviewing), random dialling
Screener Questionnaire (2,900 average)
Determine the prevalence of chronic pain by country
Detailed Questionnaire (300)
Inclusion Criteria
Adult (18 years old or older);
Suffered pain for at least 6 months duration
Has experienced pain within the past month
Experienced pain at least several times a week
Pain intensity >5/10
Has not participated in medical studies.

6. Pain in Europe: Countries Covered

7. The Data

8. Prevalence

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)
Severe
Moderate

11. Patients Forced to Live in Pain
On average, sufferers live with chronic pain for 7 years
A 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 time
Frequency
(n=4,839)
Source: SQ8. How often do you experience pain? (Read list) SQ7. When was the last time you experienced pain? (Read list)

13. Nature of Chronic Pain

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 back
Most 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 more
Tolerance 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?

16. Quality of Life

17. Chronic Pain is Insidious
Over 40% of sufferers report feelings of helplessness or inability to think or function normally
One in six say the pain is sometimes so bad they want to die

18. Chronic Pain is Insidious%
* Higher=Agree more strongly with the statement
Source: 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 sufferers
Chronic pain impacts on daily activities such as lifting, exercising, sleeping and working outside
One quarter (26%) feel that their pain impacts employment
15 working days a year are lost to pain (estimate on 6 month data)
One in five reports
losing a job (19%)
or have been diagnosed with depression as a result of their pain (21%)

20. And Can Devastate Lives
Weighted Total
UK (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 job
19%
25%
15%
14%
17%
22%
24%
29%
Changed job responsibilities
16%
12%
11%
28% 8%
21%
Changed jobs entirely
13%
18%
20% 4%
Been diagnosed with depression
Source: 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 job
29%
15%
22%
16%
20%
25%
Changed job responsibilitie s 9%
19%
24%
17%
Changed jobs entirely
14%
23%
12%
11%
Been diagnosed with depression
18%
21%

22. Doctors and Patient Relationships Revealed

23. Patients See Different Clinicians But Rarely Pain Specialists
Consultations were most frequently with GPs
Orthopaedists and to a lesser degree Rheumatologists and Neurologists are also seen
Only 23% report seeing an actual pain specialist

24. Chronic Pain Patients See Many Different Clinicians
Physician Specialty
% Who See
General/Family Practitioner
Orthopaedist/Orthopaedic Surgeon
Rheumatologist
Neurologist//Neurosurgeon
Internist
Physiotherapist
General Surgeon
Pain Management Specialist
Osteopath
Other *
When asked specifically whether ever been to a pain management specialist
70%
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 Defended
The 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 = better
Source: 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 pain
A sizeable proportion (43%) of chronic pain sufferers believe that their physicians are more focused on their illness than their pain
In 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 treatments
But almost as many are worried about potential side effects of pain medication

29. Feelings about Treatments%
* Higher=Agree more strongly with the statement
Source: 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 medications
Over one in four (26%) have tried then stopped taking prescription pain medication

31. Use of Prescription Medicines
Chronic Pain Sufferers Reporting
Currently Treating Their Pain in Any Way (n=4,827)
Use of Prescription Medications
To 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 medication
Other 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 Opioids
Strong Opioids
Source: 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 Total
UK (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)
NSAIDs
44%
23%
25%
54%
68%
49%
71%
27%
24%
38%
Weak Opioids
50%
19%
20% 9%
13%
28%
36% 8%
Paracetamol
18% 2% 6%
26%
45% 0%
COX-2 Inhibitors 3% 7% 1%
11%
Strong Opioids 5%
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)
NSAIDs
36%
42%
54%
32%
48%
58%
53%
Weak Opioids
14%
15%
22%
19%
18% 5%
Paracetamol
11%
33%
26%
12% 4% 3%
COX-2 Inhibitors
16%
13% 8%
Strong Opioids 7% 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 times
Chronic 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 pain
Majority rely on newspapers, TV and magazines
Just 5% surf the ‘Net for new options
Source: 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?

43. The Largest Pain Survey in the World