First EFIC® Symposium Societal Impact of Pain - SIP

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34 Jose M. Castro Lopes Prof. José M. Castro-Lopes MD, PhD Full professor at the Faculty of Medicine of the University of Porto, Portugal President of the National Observatory for Pain Prevalence and socio-economic impact of chronic pain in Portugal Azevedo L.F.*, Mendonça L.**, Dias C**, Costa-Pereira A*. and Castro-Lopes J.M.*** *Department of Biostatistics and Medical Informatics and Center for Research in Health Technologies and Information Systems - CIN- TESIS; ** Department of Biostatistics and Medical Informatics; *** Institute of Histology and Embryology of the Faculty of Medicine of the University of Porto and IBMC Chronic pain has been proposed as a disease in its own right and a major public health problem, with socio-economic consequences comparable to cardiovascular diseases or cancer. In order to design policies aiming at reducing the burden of chronic pain, it is essential to know its prevalence, management and socioeconomic impact. Since no data were available regarding the situation in Portugal, an epidemiological study was undertaken using the method of Computer Assisted Telephone Interview - CATI. Telephone numbers were selected by Mitofsky-Waksberg two stage random digit dialling sampling method, defining a random sample of participants nationwide, resulting in a sample of 5,094 validated interviews of individuals ≥ 18 years old. Chronic pain prevalence, as defined by pain present for at least 6 months, several times per month and present during the last month, was estimated to be 29.6% (28.2 - 30.9, 95% CI). If a pain intensity criterion was used (moderate or severe; ≥5 on a 0-10 numeric rating scale - NRS) the prevalence estimate was 14.3% (13.3 - 15.4, 95% CI). As expected, the prevalence was higher in females and increased with age, with a peak prevalence of moderate or severe chronic pain in 38.5% females belonging to the age group of 70-74 years (31.4 - 46.1, 95% CI). A more in-depth analysis was performed in those respondents reporting pain for at least 6 months and present during the last month, corresponding to 35.9% of our sample (n=2,210). Median pain duration was 10 years (5 - 20y, P25 - P75) and median average pain intensity was 5 on a 0-10 NRS (4 - 6, P25 - P75). The main location of pain was the lower back, followed by the lower limbs and neck. Osteoarthritis was the main cause of pain (42%) followed by intervertebral disk disorders (21%) and osteoporosis (15%). Pain management was carried out by family physicians of the public sector in most cases (61%), with a mean of 4.5 visits/patient/year (VPY). A specialist (secondary care) was consulted by 22% of the patients (4.3 VPY), only 1% consulted a pain specialist (4.8 VPY). A large majority of the respondents (85%) were being treated for their pain, but one in five patients reported to be dissatisfied or very dissatisfied with their pain management, attributing it to lack of efficacy of the treatment or holding their physician responsible for it. Non-steroidal anti-inflammatory drugs were used by approximately 41% of the respondents, 26% used analgesics and antipyretics and only 2% took opioids. Approximately 27% reported that they felt pain frequently or all the time while taking the prescribed drugs. In a third phase of the study, 300 patients were interviewed to evaluate the socio-economic impact of their chronic pain. Of these, 45% reported that pain interfered with their work, 9% had lost their job and 18% had early retirement directly due to their pain condition. On average, each patient had 14 days/year of sick leave. Taking into account the active population of Portugal, its average salary and the welfare costs associated with sick leave, an annual cost of approximately € 250 million was estimated. Moreover, it was estimated that each patient spent on average approximately € 70/month on direct and indirect costs associated with their pain, representing up to 35% of their family budget. In conclusion, chronic pain affects a sizeable proportion of the Portuguese adult population and its management is far from being optimal. The high costs associated with chronic pain could be substantially reduced by investing human and financial resources to increase its adequate management.
Beverly Collett Dr. Beverly Collett M.B.B.S., F.R.C.A., F.F.P.M.R.C.A Dr. Beverly Collett is a Consultant in Pain Medicine at University Hospitals of Leicester NHS Trust. She is Treasurer and Council member of the International Association for the Study of Pain (IASP), and was the facilitator for IASP’s Global Year against Pain for 2007/8 ‘Pain in Women’. She is Chair of the SIG ‘Pain of Urogenital Origin’ (PUGO). She is a Past-President of the British Pain Society and of the International Pelvic Pain Society and previously Honorary Secretary of the European Federation of IASP Chapters. She was a member of the Founding Board of the Faculty of Pain Medicine of the Royal College of Anaesthetists. She is Chair of the Chronic Pain Policy Coalition (CPPC) – a group facilitating patients, parliamentarians and health care professionals to improve pain management in the UK. Medical professionals, patients and parliamentarians working together to improve the management of chronic pain. In June 2006, the Chronic Pain Policy Coalition (CPPC) was launched to improve the lives of people who live with chronic pain by developing and sharing ideas for more effective prevention, treatment and management of persistent pain in the UK. It is an umbrella coalition of parliamentarians, health professionals and patients working together towards solutions for the management of chronic pain. The Chronic Pain Policy Coalition has produced a Five Point Pain Manifesto focusing on Education, Early Access, Empowerment, Collaboration and Measurement. We urge people to support the campaign to have pain recognised as the Fifth Vital Sign in all health care locations. The Chief Medical Officers (CMO) Report in 2008 highlighted the problem of persistent pain. The CPPC has since been working with the Department of Health, the CMOs Office and professional and patient organisations to ensure implementation of the recommendations. An All-Party Parliamentary Group for Chronic pain has now been formed and mutual close working has raised the profile of persistent pain as a public health issue. 35
Page 1 and 2: SIP Societal Impact of Pain First E
Page 3: SIP Societal Impact of Pain First E
Page 6 and 7: 6 ABOUT EFIC ® The European Federa
Page 8 and 9: 8 General Information All speakers
Page 10 and 11: 10 Floor plan CONFERENCE CENTRE/MEE
Page 12 and 13: 12 Draft program - May 4th 2010 Aud
Page 14 and 15: 14 Draft program - May 5th 2010 Par
Page 20 and 21: 20 Workshop 1 Prevalence & epidemio
Page 22 and 23: 22 SIP Societal Impact of Pain Firs
Page 24 and 25: 24 Emília Altarriba Alberch Emíli
Page 26 and 27: 26 Giovanni Apolone Giovanni Apolon
Page 28 and 29: 28 Mary Baker Mary G Baker, MBE Pre
Page 30 and 31: 30 Meindert Boysen Meindert Boysen
Page 32 and 33: 32 Ana Casas Dr. Ana Casas MD, PhD
Page 36 and 37: 36 Günter Danner Günter Danner M.
Page 38 and 39: 38 Jan Dobrogowski Prof. Jan Dobrog
Page 40 and 41: 40 Benjamin Ellis Dr. Benjamin Elli
Page 42 and 43: 42 Cornelius Erbe Dr. Cornelius Erb
Page 44 and 45: 44 Norman Evans Norman Evans Consul
Page 46 and 47: 46 Prof. Guido Fanelli MD Guido Fan
Page 48 and 49: 48 Livio Garattini Dr. Livio Garatt
Page 50 and 51: 50 Pietro Giusti Prof. Pietro Giust
Page 52 and 53: 52 Ewald Gspurning, MPH Ewald Gspur
Page 54 and 55: 54 Magdi Hanna Magdi Hanna MD Direc
Page 56 and 57: 56 Yves Henrotin Prof. Yves Henroti
Page 58 and 59: 58 Morten Hjulsager Prof. Morten Hj
Page 60 and 61: 60 Eric X. Jensen Dr. med Eric X. J
Page 62 and 63: 62 Paul Kind Prof. Paul Kind Centre
Page 64 and 65: 64 Harry Kletzko Vizepräsident Deu
Page 66 and 67: 66 Norbert Klusen Prof. Dr. Norbert
Page 68 and 69: 68 Marja R. Kuijpers Marja R. Kuijp
Page 70 and 71: 70 Pete Mackenzie Dr. Pete Mackenzi
Page 72 and 73: 72 Barbara Milani Barbara Milani Te
Page 74 and 75: 74 Laurette Onkelinx Laurette A.J.
Page 76 and 77: 76 Matthias Perleth PD Dr. med. Mat
Page 78 and 79: 78 Gina Plunkett Vice Chairperson,
Page 80 and 81: 80 Narinder Rawal Prof. Narinder Ra
Page 82 and 83: 82 Lise Rochaix Prof. Lise Rochaix
Page 84 and 85:
84 Ian Semmons Ian Semmons Chairman
Page 86 and 87:
86 Antoni Sicras Mainar Dr. Antoni
Page 88 and 89:
88 Reinhard Thoma Dr. med. Reinhard
Page 90 and 91:
90 Thomas R. Tölle Prof. Dr. med.
Page 92 and 93:
92 Martin van der Graaff Dr. Martin
Page 94 and 95:
94 Giustino Varrassi Prof. Giustino
Page 96 and 97:
96 Renata Villoro Renata Villoro Ph
Page 98 and 99:
98 Eva Zebedin-Brandl Dr. Eva Zebed
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100 NOTES
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NOTES 110 110
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First EFIC® Symposium Societal Impact of Pain - SIP

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