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News&Review No.3

4 Dr Beverly Collett THE BURDEN OF PAIN Chronic pain has an impact on all daily activities with high attendant costs for the individual sufferer, health system and society. The major proportion of this economic burden is caused by the negative impact on work productivity and activity. Chronic pain in the UK: 13% of the population suffer from chronic pain1 Approximately 25% of chronic pain patients lose their jobs1 22% develop depression1 £69 million are spent on total consultations related to oral anal- gesics and NSAIDs2 Total annual cost of back pain alone is £12.3 billion3 (Figure 2) Latest insights More recent data support the negative financial implications of chronic pain on healthcare expenses. The 2008 National Health and Wellness Survey questioned 53,524 people in France, Germany, Italy, Spain and the UK and found that increasingly se- vere pain correlated with reductions in physical and mental health, and significantly impaired social func- tioning4. The survey also found that pain sufferers use far more health- care resources. For example re- sponders with severe pain visited healthcare providers twice as often and were hospitalised three times as often as the general population. In addition, pain sufferers are em- ployed full time only half as often, miss work about 5 times as often and report activity impairment more than twice as high as the general population4. Results of this very interesting sur- vey will soon be published. References 1. Breivik H et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain, 2006, 10:287–333. 2. Belsey J. Primary care workload in the manage- ment of chronic pain: a retrospective cohort study using a GP database to identify resource implications for UK primary care. J Med Econ, 2002, 5:39–52. 3. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain, 2000, 84:95–103. 4. Kantar Health, Inc. August 2009. National Health And Wellness Survey, 2008 [EU]. Princeton, NJ. COMMENTARY Dr Beverly Collett,Treasurer and Council member of the International Association for the Study of Pain (IASP). The social, personal and economic costs of inad- equately controlled chronic pain are high. For the individual the costs are associated with a marked reduction in quality of life and normal function, while for society in general the associated eco- nomic costs are sufficiently high as to affect upon a government’s macro-economic performance. In order to ensure the best management of an individual patient’s pain it is very important that the outcomes of the discussions of the Interna- tional CHANGE PAIN Advisory Panel are accessible to a broad medical community. The CHANGE PAIN Expert Summit has been an excellent opportunity to bring together healthcare professionals dealing with pain to inform them about CHANGE PAIN and to invite them to implement the outcomes locally. EXAMPLE FOR COSTS OF BACK PAIN IN THE UK GP consults Out-patient attendance A+E attendances Day care In-patient episodes NHS Radiology Prescriptions NHS Physiotherapy Community care Private services Work days lost Informal care 74% 13% 5% 9% TOTAL COST = £12.3 billion Figure 2 (adapted from Maniadakis, Gray, 2000)