European survey of chronic pain patients: results for Germany.

OBJECTIVES: This ongoing pan-European patient survey is being conducted to explore how chronic pain patients perceive their condition and the coping strategies they use to help deal with the pain.
METHODOLOGY: Participating doctors - general practitioners (GPs), pain specialists and orthopaedists - selected patients suffering from chronic pain who routinely visited their practices. Doctors provided details of individual pain diagnoses and treatment which were entered into a questionnaire. Each patient then answered additional questions about pain experience, pain therapy, possible areas for improvement and any coping strategies used. Completed questionnaires were sent to a healthcare-focused global consultancy for analysis and evaluation.
RESULTS: The most common diagnosis was chronic back pain, in 61% of the 6435 patients. Using a five-point verbal rating scale (VRS), 70% of participants rated the intensity of their pain as moderate or severe. Approximately half were receiving monotherapy. The more intense the pain was, the higher the percentage of patients receiving combination therapy. The most frequently used combinations were NSAIDs/non-opioids with weak or strong opioids. Approximately two out of three patients received non-pharmacological treatment in addition to their pain medication. Almost all the patients (90%) perceived their pain intensity to be higher than it should be under successful pain management, and 30% were dissatisfied with their current treatment. Insufficient pain relief was the reason in most cases, but 29% of dissatisfied responders cited the side effects of medication. About half the patients identified a medium to high need for improvement in their ability to work, sleep and carry out general activities. For each specialisation, the more severe the pain, the fewer patients who were satisfied with their current pain treatment. More patients with severe and extreme pain were satisfied with treatment by a pain specialist than with a GP or orthopaedist. For all three specialisations, the most frequent combination used was NSAIDs/non-opioids with weak opioids, but pain specialists prescribed more strong opioids and fewer NSAIDS/non-opioids than the other groups. Overall, 35% of the survey subjects took pain medication not prescribed by their doctor, and coping strategies included reading, participating in sports and listening to music.
CONCLUSION: High levels of dissatisfaction, which increase proportionately with the intensity of pain, could adversely affect the chances of successful outcomes.