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6 Monotherapy 7% References 1. Kantar Health, Inc., August 2009. National Health & Wellness Survey, 2008 (EU). Prince- ton, NJ. 2. Breivik H, Collett B,Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Eu- rope: prevalence, impact on daily life, and treatment. Eur J Pain, 2006, 10: 287 333. 3. Pain in Europe Report. Published online: n/book_page/the_pain_in_europe_report. 4. Varrassia G, Müller-Schwefe G, Pergolizzi J et al. Pharmacological treatment of chronic pain – the need for CHANGE. Cur Med res Opionion, 2010, 26:1055-1069. 5. Varrassib G., Nossol S.,Wiemer S. CHANGE PAIN Physician Survey at EFIC 2009. Physi- cians' perception on management of severe chronic pain non-cancer pain. Abstracts of the 3rd International Congress on Neuro- pathic Pain. Athens, 2010. 6. Freynhagen R, Baron R, Gockel U,TolleT. Pain DETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Cur Med Res Opinion, 2006, 22:1911-1920. COMMENTARY Professor GiustinoVarrassi, President of the European Federation of ISAP Chapters (EFIC), Italy We are very pleased that so many physicians took part in the CHANGE PAIN Physician Sur- vey at the EFIC congress.The preliminary find- ings confirm many unmet medical needs identified by the CHANGE PAIN Advisory Board. We are asking all physicians treating pain patients to participate in the online survey to provide us with an even broader database, which will provide robust data on how severe chronic pain is treated across Europe.This will help us tailor the activities in our initiative to improve management of severe chronic pain. If you would like to participate in this survey please visit the website: across Europe. As yet there is no common definition of what consti- tutes severe chronic pain and no Conclusion There is a high prevalence of chronic pain in the general population consensus on the adequate approach to effective treatment, many pain sufferers are under- treated resulting in a negative im- pact on patients’ quality of life and healthcare expenditure. The first results of the CHANGE PAIN Survey are now available on the website: Paracetamol NSAIDs Classical weak opioids Fixed combinations of weak opioids Classical strong oral opioids Classical strong transdermal opioids Fixed combinations of strong opioids Antidepressants Anticonvulsants Topical analgesics Combination therapy 93% n=403 Figure 2: Pharmacological treatmet approach for severe chronic low back pain Adapted from Varrassi et al., 2010