Up to 64 per cent of people in pain, including those with musculoskeletal pain, are confused about which pain medication they should and shouldn't take, and many do not know how to manage their pain appropriately, according to the results of a global patient and physician survey announced today by the Arthritis Action Group (AAG).
The survey builds on previous AAG research, the Arthritis Research Survey, showing major inadequacies in the management of pain, and has compelled the group to call for improved communication with patients so they don't endure pain unnecessarily.
"These are disturbing findings - large numbers of people in pain are confused about treatment options and risks, and as a result do not know how to manage their pain properly," said Professor Anthony Woolf, Chairman of AAG. "Action is needed now to clear this confusion, and to support patients and physicians to manage pain effectively to reduce its pervasive impact on daily life."
The survey of 1204 people with pain, and 604 primary care physicians, was conducted by Harris Interactive, on behalf of AAG, in six countries worldwide - United Kingdom, Germany, Italy, France, Mexico and Australia.
One in five people worldwide has moderate to severe chronic pain, including 100 million Europeans with musculoskeletal pain and arthritis. People in pain report that it strongly impacts their life, affecting their ability to sleep and complete daily tasks. Not only does pain affect quality-of-life, but previous studies show that it can also predict increased mortality.
People in pain are confused and under-informed: Up to 64 per cent of people feel that conflicting information about pain medications makes it confusing to know what to take; Up to 78 per cent of people feel they don't know enough about the benefits and risks of pain medications (either prescription medications, over-the-counter medications, or both).
Many people are putting themselves at risk by using treatments inappropriately: If their pain medication doesn't work after 10 days of use, less than half of people taking prescription medication and less than half taking non-prescription medication will go to their doctor for advice or treatment. To get better pain relief, people are using strategies such as taking more of the same type of medication, taking a different type of medication, or exercising; Up to 47 per cent of people in pain don't use medication at all. Reasons include experience with or concern about side-effects, a perception they can manage without medication, their doctor advised them to stop taking medication, or because they're worried following stories in the news.
Despite patient confusion, detailed discussions about different treatment options and their specific benefits and risks are not taking place in consultation with their physician. Patients report that during their last consultation: Less than half discussed how effective their current medication was (?43 per cent), or treatment benefits (?40 per cent); Less than a third discussed potential problems or medication side-effects (?30 per cent).
Insufficient information sharing between patients and physicians was attributed to the following:
" Many physicians underestimate the level of patient concern about treatment risks. For example, up to 48% of patients are very concerned about the potential side-effects of non-prescription NSAIDs (of those who are aware of them), whereas only a small number of physicians felt their patients were very, or extremely concerned about this (?14%). Most discussions are about the benefits and risks of prescription medications.
" Up to 92% of physicians think patients don't have the expertise to evaluate the relative benefits and risks of treatment
" Up to 25% of physicians find it difficult to communicate the benefits and risks of prescription medications, and up to 24% for non-prescription pain medications
" Less than half of physicians are very familiar with the recently updated guidelines for pain medications (?49%)
" Up to 92% of physicians think their elderly patients don't want responsibility for treatment decisions
" Up to 89% of physicians see consultation time constraints as a problem.
"These survey results highlight the large gap in understanding between patients and physicians," said Sandra Canadelo, Vice Chair of the PARE Manifesto Steering Group, and Chair of the EULAR Social Leagues. "Chronic pain is hugely debilitating for patients, and severely impacts quality of life. Informed discussions are needed to ensure pain is managed effectively, and the best decisions are made to improve the lives of patients.If you are a patient who is not happy with your treatment, talk to your physician."