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ISSUE NO 6 9 NEWS & REVIEWS The results of several research pro- jects have been published in 2011 detailing the prevalence of chro- nic pain in the Spanish population and the effect it has on patients’ lives, healthcare resource utiliza- tion, and workplace productivity. An epidemiological study of chronic non-malignant pain in Spain1 which analysed the results of 112 studies was published on the CHANGE PAIN® website. This study indicated the prevalence of general chronic pain in the general population to be 12%. Many of these patients had been suffering from chronic pain for a considerable time with the mean duration of 6-14. 3 years in the case of OA and RA and 9-13 years for cases of fibromyalgia. Chronic pain was shown to affect all areas of quality of life (QOL), with chro- nic pain sufferers reporting a lower QOL than acute pain patients. Data from the 2011 National Health and Wellness Survey (NHWS) sho- wed that 17.25% of adults in Spain reported experiencing pain in the past month. Daily pain was experi- enced by 6.95% of the population. The major conditions causing pain were back pain (60.53%) follo- wed by joint pain (40.21%). Sleep difficulties (42.24%) and anxiety (40.62%) were the most commonly cited comorbidities2 . Over 70% of patients in Spain reported they were satisfied with treatment, and adherence to pain medication was high. Pain was associated with substan- tial health-related quality of life deficits as measured on by the physical and mental score com- ponents of the SF-123 . In the case of severe daily pain, there was a with 144 specialists from fields in- cluding pain, oncology, palliative care, geriatrics, rheumatology, being educated in the CHANGE PAIN® initiative. Following this, through a series of 36 CME residential courses a total of 1,260 specialists participated in the program. These meetings have highlighted the cur- rent limitations of chronic pain treat- ment due to lack of communication between physicians and patients, the difficulties of the management of opioid side effects, and the limi- ted knowledge on the pathophysio- logy of pain and available therapies. We now have a secondary pro- ject, COMPASS, devoted to GPs and strictly linked to the Ministry of Health Law 38. At present this is operating in five regions of Italy with an involvement of approxi- mately 200 GPs. This encompasses education, monitoring and evalua- ting the progress of participants. A further range of three eCME modu- les have also been running through 2011 aimed at promoting the under- standing of the underlying mecha- nisms of pain, raising awareness of the physiological differences between nociceptive and neuropa- thic pain and the available range of specific pharmacological options. It is hoped that through the im- plementation of the PAIN EDU- CATION program chronic pain treatment in Italy will be improved. Dr César Margarit-Ferri COMMENTARY Dr César Margarit-Ferri Anesthesiology, Reanimation and Pain therapy Department, General University Hospital, Alicante, Spain A number of studies have indicated the far- reaching effect of chronic pain on the lives of people in Spain from both the personal and societal perspective. Thanks to the CHANGE PAIN® initiative we have now put in place an extensive program to re-educate our physicians in dealing with chronic pain. With the incre- asing co-operation of the countries’ Health Authorities we foresee a significant benefit to chronic pain patients, their families and employers. References 1. Breivik et al. Eur J Pain. 2006; 10(4): 287 333 2. www.parlamento.it/parlam/leggi/10038l.htm EXPERIENCE IN SPAIN IN SOUTHERN EUROPE

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