Transcript PIE_slides_EUROPE1 - e

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
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
Methodology
Methodology
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 in Europe: Countries
Covered
Phone
Screen
Structured Phone
Interviews
UK
3,800
300
France
3,846
Germany
Phone
Screen
Structured Phone
Interviews
Netherlands
3,197
300
300
Belgium
2,451
301
3,832
302
Finland
2,004
303
Italy
3,849
300
Ireland
2,722
300
Spain
3,801
301
Switzerland
2,083
300
Poland
3,812
300
Austria
2,004
303
Sweden
2,563
300
Israel
2,244
322
Norway
2,018
304
Total
46,394
4,839
Denmark
2,169
303
Country
Country
The Data
Prevalence
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
Prevalence of Chronic Pain by Country
– Based on Complete Screener Data –
Overall Prevalence =
(n=46,394)
Moderate
Poland (n=3,812)
Italy (n=3,849)
Belgium (n=2,451)
Austria (n=2,004)
9%
21%
Norway (n=2,018)
8%
19%
13%
13%
19%
Severe 6%
30%
Germany (n=3,832)
27%
Israel (n=2,244)
5%
12%
7%
17%
10%
17%
13%
26%
Denmark (n=2,169)
10%
6%
16%
8%
23%
Switzerland (n=2,083)
10%
6%
16%
4%
21%
France (n=3,846)
10%
5%
15%
15%
17%
Finland (n=2,004)
12%
7%
19%
Ireland (n=2,722)
9%
4%
13%
Sweden (n=2,563)
13%
5%
18%
UK (n=3,800)
8%
5%
13%
Netherlands (n=3,197)
14%
4%
18%
0%
Spain (n=3,801) 5%
50%
Moderate
Severe
0%
6%
11%
50%
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)
25
22
21
20
20
17
15
10
5
8
8
4
0
6 Months
to <1 Year
1 to <2
2 to <5
5 to <10
10 to <15
15 to <20
20 Years
Years
Years
Years
Years
Years
or More
Source: SQ6. For how long have you suffered from pain due to your illness or medical condition?
How Often Does it Hurt?
One third of sufferers report experiencing
chronic pain all the time
Frequency
(n=4,839)
34%
At All Times
35%
31%
Daily Several Times a Week
Source: SQ8. How often do you experience pain? (Read list) SQ7. When was the last time you experienced pain?
(Read list)
Nature of
Chronic Pain
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)
34
Arthritis/osteoarthritis
15
Herniated/deteriorating discs
12
Traumatic injury
8
Rheumatoid arthritis
7
Migraine headaches
6
Fracture/deterioration of spine
Nerve Damage
4
Cartilage Damage
4
Whiplash
4
3
Surgery
0
%
5
10
15
20
25
30
35
40
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…?
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)
My pain was so severe, I
could not tolerate any more
I could tolerate a little more
pain
31%
47%
18%
4%
I could tolerate somewhat
more pain
I could tolerate a lot more
pain
0%
100%
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?
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
Chronic Pain is Insidious
So me days the pain is so bad, I want to die
I am in to o much pain to take care o f myself and o ther peo ple
I feel alo ne with my pain
I feel much o lder than I really am
I canno t remember what it feels like no t to be in pain
I canno t functio n no rmally
M y pain keeps me fro m thinking o r co ncentrating clearly
B eing in pain makes me feel helpless
I feel tired all the time
M y pain is just part o f my medical co nditio n
%
0
10
20
30
40
50
60
70
80
90
* 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)
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
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%
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%
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
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
s
20%
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
Chronic Pain Patients See
Many Different Clinicians
Physician Specialty
% Who See
General/Family Practitioner
70%
Orthopaedist/Orthopaedic Surgeon
27%
Rheumatologist
Neurologist//Neurosurgeon
9%
10%
Internist
7%
Physiotherapist
6%
General Surgeon
3%
Pain Management Specialist
2%
Osteopath
2%
Other *
20%
When asked specifically whether ever been to a
pain management specialist
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?
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
%
40
36
35
28
30
26
25
20
15
10
7
5
3
0
Extremely Satisfied
Very Satisfied
Somewhat Satisfied Not Very Satisfied
Not at All Satisfied
* 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?
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
But There are Still Problems
71
I tell him/her
52
Doctor examines me
Doctor asks me to move the
part of my body that is in pain
15
11
Doctor asks me to walk
Doctor uses a pain scale
2
Doctor does nothing
2
1
Other
%
0
10
20
30
40
50
60
70
80
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?
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
Feelings about Treatments
I am taking so many medicines, I don't want
to take pain medicine too
M y pain is not severe enough to take pain
medicine
I am afraid of being addicted to pain
medicine
I would spend all my money on pain
treatment if I knew it would work
I would rather take medication for my illness
than my pain
I worry about the side effects of pain
medicine
I am always willing to try a new treatment for
pain
0
10
20
30
40
50
60
70
%
* 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)
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
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)
26%
31%
53%
69%
Not Treating
21%
Treating
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?
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
Use of Prescription Medicines
50
%
45
Weak Opioids
40
35
44
30
Strong Opioids
25
18
20
23
15
10
6
5
3
5
3
3
2
Triptan
Anti-Epileptic
0
NSAID
Narcotic
Analgesic
Paracetamol
COX-2
Inhibitor
Barbiturate
Ergotamine
Tricyclic/
SSRI/SNRI
Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been
discussing?
Classes of Prescription Pain Medications Chronic Pain Sufferers Report
Currently Using for Pain
– European Summary –
(n=2,063)
50%
44%
23%
18%
6%
5%
3%
3%
3%
2%
2%
1%
1%
0%
N
SA
ID
W
k
ea
O
d
oi
i
p
ol
m
ta
e
c
ra
2
a
XP
O
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r
to
i
b
hi
n
I
d
oi
i
p
O
e
in
am
t
o
g
SR
g
n
S
/
Er
ro
t
ic
e
l
S
t
yc
ra
c
u
i
t
Tr
bi
r
a
B
N
I/S
RI
an
t
ip
Tr
D
M
AR
D
/
id
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t
S
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an
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Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been discussing?
t
C
a/
t
e
C
B
ke
c
lo
r
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
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)
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%
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)
Use of Non- Prescription
Medicines
Non-Prescription (OTC) Classes and Medications Chronic Pain Sufferers Report
Currently Using for Pain
(n=1,914)
100%
55%
43%
13%
0%
NSAID
Paracetamol
Weak Opioid
Source: Q18. Which prescription pain medicines are you currently taking for the specific pain we have been
discussing?
Alternative Therapies
35
31
%
30
30
25
21
20
15
13
10
10
9
8
5
3
3
3
Cold
Herbal supps
4
Diet/special foods
5
2
0
Therapy
Relaxation therapy
Nerve stimulation
Exercise
Heat
Ointment/creams
Acupuncture
Physical therapy
Massage
None
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
How Patients Rate Treatments
Pain from Activity
(n=4,787)
Adequacy of Pain Control
from Medication
(n=2,450)
21%
36%
64%
79%
Experience Pain from Activity
Pain Medication Inadequate at Times
Do Not Experience Pain from Activity
Pain Medication is Adequate
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?
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?
Learning About New
Pain Treatments
Where Chronic Pain Sufferers Report Hearing About
New Pain Treatments
(n=4,586)
%
45
40
39
35
33
30
27
24
25
20
14
15
10
5
4
Internet
Pharmacy
5
0
Magazines/
Newspapers
Television
Doctor's Office
Friends, Family,
Coworkers
Do Not Hear
About New
Methods
Source: Q36. Where do you hear about new methods for treating pain?
The Largest Pain Survey in the
World