To date, little is known of the economical and societal burden of pain in terms of healthcare resources among the European countries. Few pan-European studies have reported the prevalence and the sociodemographic characteristics of adult patients experiencing pain. The latest, published in 2011, is an internet-based, cross-sectional study of the healthcare attitudes, behaviors, and characteristics of the adult population in the United States, Japan and five European countries. From this study, it is known that one in five of the adult population of the top five European countries had reported pain in the previous month. This fact presents a major challenge for policy makers to reduce the incidence and prevalence of chronic pain in the community, as well as manage existing populations suffering from pain.
The Spanish Pandhora study has evaluated the sociodemographic and clinical profile of patients attending Spanish Hospital Pain Units (PU) for the first time. 107 Pain Units in Spanish hospitals took part in the study with a total of 823 patients. As expected, the number of females attending Pus was greater than for males (66.4% vs 33.6%). The referring specialists were orthopedics (35.1% of patients), followed by primary care practitioners (24.9% of patients). 96.3% of patients presented non-oncologic pain with musculoskeletal pain predominated in 68.6%. 7.8% of patients were receiving no analgesic treatment, while 55.2% were on non-steroid anti-inflammatory drugs (NSAIDs), 45.1% on acetaminophen, 31.6% on minor opioids, and 15.7% on major opioids. However, an increase in opioid prescription was observed in all PUs, in both adults and children, making the most newly launched drugs also the most prescribed. In more than 50% of the patients attending PUs for the first time, physicians used alternative therapies to those used in patients experiencing chronic severe uncontrolled pain.
Discrepancies exist between referring specialists and PU physicians regarding management of chronic pain. The lack of Spanish guidelines to effectively manage pain in the long term is a major concern. Whether pain should be considered a disease in its own right, or managed as part of traditional disease intervention strategies, is still to be resolved. Even so, the benefits of aligned pain management strategies between PUs and primary care would appear to be substantial.
Langley, PC. CMRO (2011) 27(2):463-480
Montero Matamala, A et al. Rev Soc Esp Dolor (2011) 18(4): 219-227
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