Patients Who Suffer Chronic Pain
Dissatisfied With Treatment

November 22 MedscapeWire

Patients in chronic pain are so dissatisfied with the efficacy of their prescription and over-the-counter (OTC) pain control medications that 78% are willing to try new treatments and 43% would spend more on a treatment if they knew it would work, according to a national survey commissioned by Partners Against Pain, an educational program sponsored by Purdue Pharma.

The survey of more than 1000 people revealed that two thirds (66%) of the surveyed pain patients said their OTC pain medication is not completely or very effective. In addition, of those who rely on prescription drugs, 52% said the therapies are not completely effective or very effective.

Many surveyed patients reported suffering from pain for years, with 62% experiencing pain for at least 5 years. Even for those patients who say their pain is under control, it often has taken a long time to get relief.

Some 43% of patients suffered for a year or more before they felt their pain was under control, and for 21% it took 5 years or longer.

"Pain is a serious public health problem for patients and the physicians who care for them. When inadequately treated, pain interferes with patients' quality of life," stated Kathleen Foley, MD, professor and neurologist at Memorial Sloan-Kettering Cancer Center and Partners Against Pain advisor.

Patients' satisfaction with their physicians closely relates to how successful the physicians are in treating them. Those not completely happy with their physician cited unsuccessful treatment (62%) as the main reason for dissatisfaction.

Survey respondents expressed their dissatisfaction through comments such as "has not helped me" and "not doing as much to heal me as he/she could."

Partners Against Pain commissioned the survey to identify the scope of pain management, including access and barriers to treatment within the United States.

According to the National Institutes of Health, pain costs Americans more than $100 billion each year in healthcare costs and lost productivity.

"The Joint Commission on Accreditation of Healthcare Organizations adopted standards that recognize the right of patients to appropriate pain assessment and management. Physicians and patients need to understand that pain can be managed," said Dr. Foley.

"Physicians must determine the severity and frequency of their patients' pain experience to prescribe the most appropriate and effective pain management regimen. Pain treatment needs to be individualized."

Many of the surveyed patients believe their family is tired of hearing about their pain-related problems, such as quality of life issues, and feel that their family doesn't understand how their pain affects their life. Forty percent of patients surveyed are uncomfortable discussing their pain with family and friends, and 37% say it can be isolating.

While many aspects of daily living are affected by pain, interference with sleeping ranked first with a majority of surveyed patients (56%). They also report that pain affects their overall mood, (51%), ability to drive (30%), ability to have sexual relations (28%), and ability to feed themselves (7%).

In their search for relief, many chronic pain patients reported extensive efforts.

On average, they have seen 3 physicians for their pain and have taken 3.7 different kinds of prescription medications as part of their pain treatment.

Those who suffer from severe or constant pain traveled far for help, with more than 20% of surveyed patients traveling 51 miles or more for treatment.

Patients reported generally receiving treatment first with OTC medications such as aspirin, acetaminophen, nonsteroidal anti-inflammatories (NSAIDs), and physical therapy according to their needs.

The range of prescription pain treatments includes NSAIDs, COX-2 inhibitors, low dose antidepressants, anticonvulsants, and opioid analgesics.

In addition, 80% of patients surveyed thought that their pain was a normal part of their medical condition and something with which they must live. For one third of sufferers, their chronic pain is so severe and debilitating, they feel they can't function as normal people and sometimes is so bad they want to die.

Among the survey respondents, 48% experienced pain related to skeletal problems, which include back pain, as well as problems with the knees, neck, shoulder/arm, ankle/foot, joints, bones, hips and bursitis; and other sources included arthritis (28%), headaches (16%), nerve problems (10%), surgical/postoperative (4%), and traumatic injury (2%).