Pain in Europe UK

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Pain in Europe - UK -
The Pain in Europe Survey was sponsored by
Mundipharma International/Napp Pharmaceuticals
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The Pain in Europe Research

• Largest survey ever undertaken into pain
• Prevalence data based on gt46,000 interviews
  (3,800 for UK alone)
• Attitudinal data from almost 5,000 interviews
  (300 for UK alone)
• Striking results demonstrate the devastating
  impact of chronic pain

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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

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Methodology
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Methodology

• CATI (Computer Assisted Telephone Interviewing),
  Random dialling
• Screener Questionnaire (3,800)
• 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 gt5/10
• Has not participated in medical studies.

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• The Data

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Prevalence
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Pain - A Widespread Problem

• Almost one in seven people in the UK suffers from
  chronic pain (7.8 million people)
• One-third of UK households are affected by
  chronic pain
• Regionally
• North East/Yorkshire 9.0
• North West 16.5
• East Midlands 9.3
• West Midlands 17.5
• East 12.9
• London 14.3
• South East 13.2
• South West 13.4
• Wales 9.9
• Scotland 18.1
• Northern Ireland 19.0

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For Men and Women of All Ages

• Woman (49) and men (51) are equally liable to
  suffer from chronic pain
• Average age of sufferers is 49

Source SQ4. Record sex from voice. SQ5. How
old were you on your last birthday? US Census
Bureau International Database (IDB), Summary of
Demographic Information. October 2002 estimates.
http//www.census.gov/ipc/www/idbnew.html
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Patients Forced to Live in Pain

• On average, sufferers had lived with chronic pain
  for 5.9 years
• A fifth had lived with pain for more than 20 years

Duration of Pain Reported by Chronic Pain
Sufferers United Kingdom (n300)
Source SQ6. For how long have you suffered
from pain due to your illness or medical
condition?
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How Often Does it Hurt?

• Two thirds of sufferers report experiencing
  chronic pain all the time (70)

Frequency United Kingdom (n300)
Source SQ8. How often do you experience pain?
(Read list) SQ7. When was the last time you
experienced pain? (Read list)
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Nature of Chronic Pain
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Where does it hurt?

• The most frequent cause of chronic pain is
  arthritis / osteoarthritis (40)
• The most common location is the lower back

Most Common Causes of Pain Reported by Chronic
Pain Sufferers United Kingdom (n272)

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?
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And How Much?

• One third reported that their pain was so severe
  they could not tolerate any more

Tolerance Level for More Pain United Kingdom
(n293)
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?
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Quality of Life
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Chronic Pain is Insidious

• 50 of chronic pain sufferers
• Feel tired all the time
• Feel helpless
• Feel older than they really are
• Do not remember what it feels like not to be in
  pain
• One in five say the pain is sometimes so bad they
  want to die

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Chronic Pain is Insidious

HigherAgree 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
1Disagree Completely, 2Disagree Somewhat,
3Neither Agree nor Disagree, 4Agree Somewhat,
and 5Agree Completely. (Read list)
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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 third (35) feel that their pain impacts
  employment
• 12 working days a year are lost to pain (estimate
  on 6 month data)
• One in four reports
• losing a job (25)
• or have been diagnosed with depression as a
  result of their pain (24)

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And Can Devastate Lives

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?
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Doctors and Patient Relationships Revealed
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Patients See Different Clinicians But Rarely Pain
Specialists

• Consultations occurred most frequently with GPs
• Orthopedic surgeons and to a lesser degree
  Rheumatologists and Neurologists are also seen
• Only 2 report seeing an actual pain specialist
  (unprompted)

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Chronic Pain Patients See Many Different
Clinicians

• Physician Specialty

Who See
General/Family Practitioner Orthopedic
Surgeon Rheumatologist Neurologist//Neurosurgeon I
nternist Physiotherapist General Surgeon Pain
Management Specialist Osteopath Other When
asked specifically whether ever been to a pain
management specialist
72 11 2 5 0 5 1 2 2 9 16
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?
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Doctors Defended

• The majority (70) 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?
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But There are Still Problems

• Some patients worry about their doctors
  willingness and commitment to treating their pain
• A sizeable proportion (39) 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 (3
  unprompted)
• Most discussions are patient initiated

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But There are Still Problems

Source Q37. disagree with each statement using
a 5-point scale where 1Disagree Completely,
2Disagree Somewhat, 3Neither Agree nor
Disagree, 4Agree Somewhat, and 5Agree
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?
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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

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Feelings about Treatments

HigherAgree 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 1Disagree
Completely, 2Disagree Somewhat, 3Neither Agree
nor Disagree, 4Agree Somewhat, and 5Agree
Completely. (Read list)
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Use of Prescription Medicines

• Pain sufferers are proactive with 80 of chronic
  pain sufferers treating their pain in some way,
  mainly via prescription medications
• Over one in five (22) have tried then stopped
  taking prescription pain medication

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Use of Prescription Medicines
Chronic Pain Sufferers Reporting Currently
Treating Their Pain in Any Way United Kingdom
(n300)
Use of Prescription Medications To Treat Chronic
Pain United Kingdom (n299)
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?
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Use of Prescription Medicines

• Weak opioids (50) are most used class of pain
  medication
• Other commonly prescribed drugs are paracetamol
  (38), and NSAIDs (23)
• Mean number of pills taken everyday is 5.7

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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?
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Use of Non- Prescription Medicines
Non-Prescription (OTC) Classes and Medications
Chronic Pain Sufferers Report Currently Using for
Pain United Kingdom (n110)
Source Q18. Which prescription pain medicines
are you currently taking for the specific pain we
have been discussing?
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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?
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How Patients Rate Treatments

• The majority (68) 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

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How Patients Rate Treatments
Adequacy of Pain Control from Medication
United Kingdom (n186)
Pain from Activity United Kingdom (n299)
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?
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Learning About New Pain Treatments

• Nearly a third of all chronic pain sufferers feel
  they never hear about new methods of treating
  pain
• Majority rely on newspapers, TV and magazines
• Just 8 surf the internet for new options

Source Q36. Where do you hear about new
methods for treating pain?
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Learning About New Pain Treatments
Where Chronic Pain Sufferers Report Hearing About
New Pain Treatments United Kingdom (n293)

Source Q36. Where do you hear about new
methods for treating pain?
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The Pain in Europe Survey was sponsored by
Mundipharma International/Napp Pharmaceuticals