“This research reveals an alarmingly high prevalence of uncontrolled chronic pain in our communities. This serious public health problem must be addressed as a matter of urgency.” – Dr. Tony O'Brien, MD
Fully 95% of patients are suffering from moderate to severe chronic pain after one year of treatment and only 12% are being prescribed strong opioids, according to a year-long survey presented Sep 10 at the EFIC Pain Congress in Lisbon (European Federation of Chapters of the International Association for the Study of Pain).
The research reveals that:
• More than half of patients' pain levels fail to improve over the course of a year's treatment, and for 19%, their pain has become worse.
• Despite the high proportion of patients continuing to suffer pain, 64% of patients believe they are taking the most appropriate level of medication and 58% believe that everything is being done to help them.
The new survey, entitled PainSTORY* (Pain Study Tracking Ongoing Responses for a Year), is the first of its kind to track the impact of chronic pain on patients' lives over the course of a year, and involved 294 patients in 13 European countries.
Regarding pain management, the survey demonstrates that out of all patients who took part in the survey:
• 83% are prescribed medication but 30% also resort to over the counter (OTC) medication to try to manage their pain either alone or in combination with other therapies.
• Despite the fact that 95% of patients receiving treatment are suffering from moderate-to-severe pain, only 12% of them are being prescribed a strong opioid treatment, 25% a weak opioid, and 43% are prescribed a non-opioid treatment.
• The research also reveals that only 23% had their prescription changed to a stronger type of pain medication over the course of the year.
The survey illustrates that almost half of all patients report side effects as a result of their medication, the most common of which is constipation, experienced by almost half of patients, 49% of whom are receiving treatment with opioids.
• Although highly effective in controlling pain, opioids can be associated with opioid-induced constipation (OIC).
• The research indicates that 26% of patients taking opioid medication turn to laxatives to help relieve their constipation, which may alleviate symptoms but will not address the cause of the problem.
Commenting on the findings, Dr. Tony O'Brien, Consultant Physician in Palliative Medicine at Cork University Hospital, said:
"This research reveals an alarmingly high prevalence of uncontrolled chronic pain in our communities. This serious public health problem must be addressed as a matter of urgency. Patients suffering pain require comprehensive evaluation and assessment by skilled healthcare professionals.
“Selected patients will benefit from a supervised trial of opioid medication in order to achieve an optimal level of analgesia, whilst preventing unwanted opioid adverse effects, including opioid induced constipation. The objective is to ensure that patients can experience the best possible quality of life.”
The research provides some valuable insights into patients' experience of the healthcare professional team.
Despite the high proportion of patients continuing to suffer pain, the number of patients visiting a doctor declined over the course of the year from 83% at the beginning of the survey to 70% at the end. By the end of the survey:
• 58% had been given a physical examination,
• 22% were rated on a pain scale,
• 19% were sent for further tests,
• And only 2% had seen a pain specialist consistently throughout the year.
Severe Psychic Toll…
Across the year, 44% of patients report feeling alone in tackling their pain and two-thirds of patients feel anxious or depressed as a result of their pain. For 28% of patients, their pain is so bad they report they sometimes want to die. Patients report feeling trapped by a pain which may vary in intensity, but continuously affects every aspect of their life.
Commenting on the findings of the survey, EFIC President Elect Hans Kress, a professor at the Medical University of Vienna, said:
"This research presents a unique insight into patients' journey in pain across Europe. It is shocking to observe that one year on, patients are still trapped in an ongoing cycle of pain and a large proportion seem to be losing hope. I urge patients to speak to their doctor if they are experiencing chronic pain or are concerned about side effects, and not suffer in silence.”
* To learn more about the PainSTORY survey, view videos of survey patients’ stories, review the full report, and post comments, go to http://www.painstory.org/Survey.aspx?SS=RESULTS&id=6
Source: European Federation of Chapters of the International Association for the Study of Pain (EFIC) news release, Sep 10, 2009.