Journal of Pain & Palliative Care Pharmacotherapy. 2013;27:397–398. ISSN: 1536-0288 print / 1536-0539 online DOI: 10.3109/15360288.2013.847521
EUROPEAN PERSPECTIVES ON PAIN AND PALLATIVE CARE
Pain Management Discussion Forum
J Pain Palliat Care Pharmacother Downloaded from informahealthcare.com by University of Bath on 11/02/14 For personal use only.
Harald Breivik A B STRA CT A query and response address comparative chronic pain management in European countries and the availability of psychotherapy services in pain management. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. KEYWORDS pain, chronic, management, effectiveness, psychology, costs
Response
QUERY
Thank you for this important question. You may have read the paper on prevalence, impact and therapy of chronic noncancer pain in 15 countries in Europe plus Israel in the European Journal of Pain in 20061 and a similar study documenting prevalence and treatment of pain related to cancer published in the Annals of Oncology in 2009, covering 11 European countries plus Israel.2 Switzerland was represented in the cancer pain survey but not in the noncancer survey. These and other European studies document the immense burden from chronic pain on individual patients and their families, but also the major cost to health and social budgets.3,4 There are also a number of high-quality studies which show that treatment at a pain clinic will increase the quality of life of painpatients and reduce the economic burden on health budgets, much more than the cost of running pain clinics.5,6 Cancer pain and chronic noncancer pain are common health problems in all countries in Europe.1,2 Almost half of the patients indicate that their pain is not managed satisfactorily.1,2 This varies from country to country, but even these large studies are not really powered to find statistically significant differences between countries.1,2
Several years ago, I read an article which compared the effectiveness of pain management programs for chronic pain patients across European countries. I can no longer find this article, but I remember that Switzerland was not in a good position. Do you know any European studies that measure this issue? Are there also percentages of the costs for chronic pain in the different countries? I would be very grateful if you could help me. I am a psychotherapist in Switzerland, working to create an ambulant interdisciplinary program for chronic pain patients, in which training therapy and psychotherapy would be very important. ¨ PsyIris Christa Kohler, Fachpsychologin fur chotherapie FSP, Praxis, Bern, Switzerland Harald Breivik, MD, DMSc, FRCA, is Emeritus Professor of Anesthesiology, University of Oslo, Oslo, Norway. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. Address correspondence to: Dr. Harald Brievik, Division of Anesthesiology and Intensive Care, Rikshospitalet University Hospital, 0027 Oslo Norway (E-mail: [email protected]).
397
J Pain Palliat Care Pharmacother Downloaded from informahealthcare.com by University of Bath on 11/02/14 For personal use only.
398
H. Breivik
The impression I have of pain medicine in Switzerland is that pain patients there are no worse off than patients in other countries in Europe. This is based on my experience working for almost a year in Bern as a visiting professor of anesthesiology and pain medicine. A considerable number of excellent pain studies come from Swiss pain clinicians, notably from Bern University Hospital (Inselspital) where Professor Michele Curatolo has been Chair of the Multidisciplinary Pain Centre there, for more than 10 years and has been working with clinical pain problems for more than 20 years.7–9 The Swiss Pain Society, a national chapter of the International Association for the Study of Pain has been active in improving pain medicine for many years. However, as in most countries in Europe, in Switzerland there are too few clinical psychologists with interest and experience in pain medicine. Therefore, I am sure you will be very welcome in Bern by physicians as well as other health providers striving to improve the management of acute as well as chronic pain, in cancer as well as noncancer conditions. Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.
REFERENCES [1] Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European J Pain. 2006;10(4):287–333. [2] Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, Cohen R, Dow L. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009;20(8):1420–1433. [3] Gustavsson A, Bjorkman J, Ljungcrantz C, Rhodin A, RivanoFischer M, Sjolund KF, Mannheimer C. Socio-economic burden of patients with a diagnosis related to chronic pain–register data of 840,000 Swedish patients. European J Pain. 2012;16(2):289–299. [4] Raftery MN, Sarma K, Murphy AW, De la Harpe D, Normand C, McGuire BE. Chronic pain in the Republic of Ireland–community prevalence, psychosocial profile and predictors of pain-related disability: results from the Prevalence, Impact and Cost of Chronic Pain (PRIME) study, part 1. Pain. 2011;152(5):1096–1103. [5] Heiskanen T, Roine R, Kalso E. Multidisciplinary pain treatment–Which patients do benefit? Scandinavian J Pain. 2012;3(4):201–7. [6] Eriksen J. Long-term chronic non-cancer pain. Epidemiology, health-care utilization, socioeconomy and aspects of treatment. Medical Doctoral Thesis, Faculty of Health Sciences, University of Copenhagen, Copenhagen, 2004. [7] Curatolo M. Appropriate interventional management of whiplash-associated pain disorders is effective. Scandinavian J Pain. 2012:3(4):236–237. [8] Curatolo M. Pharmacological modulation of chronic pain after whiplash injury. Scandinavian J Pain. 2012:3(3):149–150. [9] Sterling M, Hodkinson E, Pettiford C, Curatolo M. Psychologic factors are related to some sensory pain thresholds but not nociceptive flexion reflex threshold in chronic whiplash. Clin J Pain. 2008;24(2):124–130.
Journal of Pain & Palliative Care Pharmacotherapy
EUROPEAN PERSPECTIVES ON PAIN AND PALLATIVE CARE
Pain Management Discussion Forum
J Pain Palliat Care Pharmacother Downloaded from informahealthcare.com by University of Bath on 11/02/14 For personal use only.
Harald Breivik A B STRA CT A query and response address comparative chronic pain management in European countries and the availability of psychotherapy services in pain management. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. KEYWORDS pain, chronic, management, effectiveness, psychology, costs
Response
QUERY
Thank you for this important question. You may have read the paper on prevalence, impact and therapy of chronic noncancer pain in 15 countries in Europe plus Israel in the European Journal of Pain in 20061 and a similar study documenting prevalence and treatment of pain related to cancer published in the Annals of Oncology in 2009, covering 11 European countries plus Israel.2 Switzerland was represented in the cancer pain survey but not in the noncancer survey. These and other European studies document the immense burden from chronic pain on individual patients and their families, but also the major cost to health and social budgets.3,4 There are also a number of high-quality studies which show that treatment at a pain clinic will increase the quality of life of painpatients and reduce the economic burden on health budgets, much more than the cost of running pain clinics.5,6 Cancer pain and chronic noncancer pain are common health problems in all countries in Europe.1,2 Almost half of the patients indicate that their pain is not managed satisfactorily.1,2 This varies from country to country, but even these large studies are not really powered to find statistically significant differences between countries.1,2
Several years ago, I read an article which compared the effectiveness of pain management programs for chronic pain patients across European countries. I can no longer find this article, but I remember that Switzerland was not in a good position. Do you know any European studies that measure this issue? Are there also percentages of the costs for chronic pain in the different countries? I would be very grateful if you could help me. I am a psychotherapist in Switzerland, working to create an ambulant interdisciplinary program for chronic pain patients, in which training therapy and psychotherapy would be very important. ¨ PsyIris Christa Kohler, Fachpsychologin fur chotherapie FSP, Praxis, Bern, Switzerland Harald Breivik, MD, DMSc, FRCA, is Emeritus Professor of Anesthesiology, University of Oslo, Oslo, Norway. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. Address correspondence to: Dr. Harald Brievik, Division of Anesthesiology and Intensive Care, Rikshospitalet University Hospital, 0027 Oslo Norway (E-mail: [email protected]).
397
J Pain Palliat Care Pharmacother Downloaded from informahealthcare.com by University of Bath on 11/02/14 For personal use only.
398
H. Breivik
The impression I have of pain medicine in Switzerland is that pain patients there are no worse off than patients in other countries in Europe. This is based on my experience working for almost a year in Bern as a visiting professor of anesthesiology and pain medicine. A considerable number of excellent pain studies come from Swiss pain clinicians, notably from Bern University Hospital (Inselspital) where Professor Michele Curatolo has been Chair of the Multidisciplinary Pain Centre there, for more than 10 years and has been working with clinical pain problems for more than 20 years.7–9 The Swiss Pain Society, a national chapter of the International Association for the Study of Pain has been active in improving pain medicine for many years. However, as in most countries in Europe, in Switzerland there are too few clinical psychologists with interest and experience in pain medicine. Therefore, I am sure you will be very welcome in Bern by physicians as well as other health providers striving to improve the management of acute as well as chronic pain, in cancer as well as noncancer conditions. Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.
REFERENCES [1] Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European J Pain. 2006;10(4):287–333. [2] Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, Cohen R, Dow L. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009;20(8):1420–1433. [3] Gustavsson A, Bjorkman J, Ljungcrantz C, Rhodin A, RivanoFischer M, Sjolund KF, Mannheimer C. Socio-economic burden of patients with a diagnosis related to chronic pain–register data of 840,000 Swedish patients. European J Pain. 2012;16(2):289–299. [4] Raftery MN, Sarma K, Murphy AW, De la Harpe D, Normand C, McGuire BE. Chronic pain in the Republic of Ireland–community prevalence, psychosocial profile and predictors of pain-related disability: results from the Prevalence, Impact and Cost of Chronic Pain (PRIME) study, part 1. Pain. 2011;152(5):1096–1103. [5] Heiskanen T, Roine R, Kalso E. Multidisciplinary pain treatment–Which patients do benefit? Scandinavian J Pain. 2012;3(4):201–7. [6] Eriksen J. Long-term chronic non-cancer pain. Epidemiology, health-care utilization, socioeconomy and aspects of treatment. Medical Doctoral Thesis, Faculty of Health Sciences, University of Copenhagen, Copenhagen, 2004. [7] Curatolo M. Appropriate interventional management of whiplash-associated pain disorders is effective. Scandinavian J Pain. 2012:3(4):236–237. [8] Curatolo M. Pharmacological modulation of chronic pain after whiplash injury. Scandinavian J Pain. 2012:3(3):149–150. [9] Sterling M, Hodkinson E, Pettiford C, Curatolo M. Psychologic factors are related to some sensory pain thresholds but not nociceptive flexion reflex threshold in chronic whiplash. Clin J Pain. 2008;24(2):124–130.
Journal of Pain & Palliative Care Pharmacotherapy
