pain in europe survey pan-european results
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Pain in Europe Survey
Pan-European Results
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
ObjectivesEstimate 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
Methodology
MethodologyCATI (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.
Country Phone Screen
Structured Phone Interviews
UK 3,800 300
France 3,846 300
Germany 3,832 302
Italy 3,849 300
Spain 3,801 301
Poland 3,812 300
Sweden 2,563 300
Norway 2,018 304
Denmark 2,169 303
Country Phone Screen
Structured Phone Interviews
Netherlands 3,197 300
Belgium 2,451 301
Finland 2,004 303
Ireland 2,722 300
Switzerland 2,083 300
Austria 2,004 303
Israel 2,244 322
Total 46,394 4,839
Pain in Europe: Countries Covered
The Data
Prevalence
Pain - A Widespread ProblemStrikes 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
Prevalence of Chronic Pain by Country– Based on Complete Screener Data –
14%
13%
12%
17%
15%
13%
19%
21%
8%
13%
8%
9%
4%
5%
7%
4%
0% 50%
5%
8%
9%
10%
10%
10%
7%
12%
6%
6%
10%
5%
5%
4%
5%
6%
0% 50%
SevereModerate
Norway (n=2,018)
Poland (n=3,812)
Italy (n=3,849)
Belgium (n=2,451)
Finland (n=2,004)
Austria (n=2,004)
Sweden (n=2,563)
Netherlands (n=3,197)
Germany (n=3,832)
Israel (n=2,244)
Denmark (n=2,169)
Switzerland (n=2,083)
France (n=3,846)
UK (n=3,800)
Ireland (n=2,722)
Spain (n=3,801)
30%
27%
26%
23%
21%
19%
18%
18%
17%
17%
16%
16%
15%
13%
13%
11%
Overall Prevalence = 19% (n=46,394)
Moderate 13% Severe 6%
Overall Prevalence = 19% (n=46,394)
Moderate 13% Severe 6%
4
8
22
20
17
8
21
0
5
10
15
20
25
6 Months to <1 Year
1 to <2 Years
2 to <5 Years
5 to <10 Years
10 to <15 Years
15 to <20 Years
20 Years or More
Source: SQ6. For how long have you suffered from pain due to your illness or medical condition?
Duration of Pain Reported by Chronic Pain Sufferers(n=4,839)
Patients Forced to Live in PainOn average, sufferers live with chronic pain for 7 years
A fifth suffer with pain for more than 20 years
%
Source: SQ8. How often do you experience pain? (Read list) SQ7. When was the last time you experienced pain? (Read list)
How Often Does it Hurt?One third of sufferers report experiencing chronic pain all the time
35%
31%
34%
At All Times Daily Several Times a Week
Frequency (n=4,839)
Nature of Chronic Pain
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…?
7
6
4
4
4
3
34
15
12
8
0 5 10 15 20 25 30 35 40
Arthritis/osteoarthritis
Herniated/deteriorating discs
Traumatic injury
Rheumatoid arthritis
Migraine headaches
Fracture/deterioration of spine
Nerve Damage
Cartilage Damage
Whiplash
Surgery
Most Common Causes of Pain Reported by Chronic Pain Sufferers(n=4,292)
Where does it hurt?The most frequent cause of chronic pain is arthritis / osteoarthritis (34%)
The most common location is the lower back
%
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?
Tolerance Level for More Pain(n=4,785)
31% 47% 18% 4%
0% 100%
My pain was so severe, Icould not tolerate any more
I could tolerate a little morepain
I could tolerate somewhatmore pain
I could tolerate a lot morepain
And How Much?One third reported that their pain was so severe they could not tolerate any more
Quality of Life
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
0 10 20 30 40 50 60 70 80 90
My pain is just part of my medical condition
I feel tired all the time
Being in pain makes me feel helpless
My pain keeps me from thinking or concentrating clearly
I cannot function normally
I cannot remember what it feels like not to be in pain
I feel much older than I really am
I feel alone with my pain
I am in too much pain to take care of myself and other people
Some days the pain is so bad, I want to die
* 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)
Chronic Pain is Insidious
%
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%)
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?
And Can Devastate Lives
WeightedTotal
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% 14% 24% 24% 29%
Changed job responsibilities
16% 16% 12% 11% 28% 8% 19% 28% 28% 21%
Changed jobs entirely
13% 18% 12% 8% 20% 4% 13% 25% 22% 11%
Been diagnosed with depression
21% 24% 18% 20% 22% 29% 14% 24% 28% 11%
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% 15% 16% 20% 25%
Changed job responsibilitie
s20% 9% 19% 24% 15% 20% 17%
Changed jobs entirely
16% 9% 14% 23% 12% 11% 14%
Been diagnosed
with depression
19% 19% 22% 19% 18% 21% 16%
Doctors and Patient Relationships Revealed
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
* 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?
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%
2%
20%
23%
3
26
36
28
7
0
5
10
15
20
25
30
35
40
Extremely Satisfied Very Satisfied Somewhat Satisfied Not Very Satisfied Not at All Satisfied
* 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?
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
%
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
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?
2
2
1
71
52
15
11
0 10 20 30 40 50 60 70 80
I tell him/her
Doctor examines me
Doctor asks me to move the part of my body that is in pain
Doctor asks me to walk
Doctor uses a pain scale
Doctor does nothing
Other
But There are Still Problems
%
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
* 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)
Feelings about Treatments
0 10 20 30 40 50 60 70
I am always willing to try a new treatment forpain
I worry about the side effects of painmedicine
I would rather take medication for my illnessthan my pain
I would spend all my money on paintreatment if I knew it would work
I am afraid of being addicted to painmedicine
My pain is not severe enough to take painmedicine
I am taking so many medicines, I don't wantto take pain medicine too
%
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
53%
21%
26%
Lapsed
Never Taken
Currently Taking
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?
Chronic Pain Sufferers Reporting Currently Treating Their Pain in Any Way
(n=4,827)
69%
31%
Not Treating Treating
Use of Prescription MedicationsTo Treat Chronic Pain
(n=4,839)
Use of Prescription Medicines
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
44
18
63 3
325
23
0
5
10
15
20
25
30
35
40
45
50
NSAID Narcotic Analgesic
Paracetamol COX-2 Inhibitor
Barbiturate Ergotamine
Tricyclic/SSRI/SNRI
Triptan Anti-Epileptic
Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing?
Use of Prescription Medicines%
Weak Opioids
Strong Opioids
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?
44%
23%18%
6% 5% 3% 3% 3% 2% 2% 1% 1%0%
50%
WeightedTotal
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 23% 50% 19% 20% 9% 13% 28% 36% 50% 8%
Paracetamol 18% 38% 38% 2% 6% 8% 8% 26% 45% 0%
COX-2 Inhibitors 6% 3% 6% 8% 7% 2% 1% 7% 11% 8%
Strong Opioids 5% 12% 4% 4% 0% 1% 4% 3% 6% 11%
Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing? (most common mentions)
Netherlands (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% 14% 5%
Paracetamol 11% 33% 26% 5% 12% 4% 3%
COX-2 Inhibitors
16% 13% 16% 8% 13% 4% 36%
Strong Opioids
5% 7% 2% 13% 2% 5% 5%
Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing? (most common mentions)
Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing?
Use of Non- Prescription Medicines
Non-Prescription (OTC) Classes and Medications Chronic Pain Sufferers Report Currently Using for Pain
(n=1,914)
55%
43%
13%
0%
100%
NSAID Paracetamol Weak Opioid
Alternative Therapies
233
45
98
10
13
21
31 30
3
0
5
10
15
20
25
30
35
None
Massage
Physical therapy
Acupuncture
Ointm
ent/creams
Heat
Exercise
Nerve stim
ulation
Relaxation therapy
Diet/special foods
Cold
Herbal supps
Therapy
%
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?
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
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?
Adequacy of Pain Control from Medication
(n=2,450)Pain from Activity
(n=4,787)
21%
79%
Experience Pain from Activity
Do Not Experience Pain from Activity
36%
64%
Pain Medication Inadequate at Times
Pain Medication is Adequate
How Patients Rate Treatments
Source: Q36. Where do you hear about new methods for treating pain?
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?
Where Chronic Pain Sufferers Report Hearing About New Pain Treatments
(n=4,586)
5 4
27
39
33
24
14
0
5
10
15
20
25
30
35
40
45
Magazines/Newspapers
Television Doctor's Office Friends, Family,Coworkers
Internet Pharmacy Do Not HearAbout NewMethods
Learning About New Pain Treatments
%
The Largest Pain Survey in the The Largest Pain Survey in the WorldWorld
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