Improving the Current and Future Management of Chronic Pain
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Improving the current and future management of chronic pain A European consensus report Acknowledgements The Pain Proposal Steering Committee The Pain Proposal Executive Committee The Pain Proposal Steering Committee is an independent group of European experts, from a range of backgrounds, with a shared interest The management of chronic pain varies widely across European countries. In order to gain a wide and representative range of perspectives, in chronic pain. The Steering Committee has taken a leading role in the development and implementation of the Pain Proposal initiative. a Pain Proposal Executive Committee of experts - including patient groups, clinicians, policy experts and health economists - was formed. Committee members have contributed their time and expertise, hosting a meeting with the Executive Committee; reviewing the questions Executive Committee members conducted work at a national level to develop a series of national Pain Proposal ‘Country Snapshot’ reports for the patient and healthcare professional surveys commissioned for this project; and assisting in the development of content for this report. providing greater detail around the chronic pain challenges in individual European countries. They also fed insights into the overall European The recommendations within this document represent a consensus from the Steering Committee of steps that could be taken to improve the Consensus Report. The Pain Proposal Steering Committee would like to thank the Executive Committee for their time and input on this management of chronic pain in Europe for the benefit of all involved. important project. Dr Mary Baker, MBE Professor Burkhard Gustorff, Head of anaesthesiology and Professor Federico Spandonaro, Scientific Coordinator of the President, European Federation of Neurological intensive care at the Vienna Wilhelminenspital, Scientific Head of CEIS, University Roma Tor Vergata EUROPE Associations (EFNA) AUSTRIA Post-Graduate Programme on Interdisciplinary Pain Treatment at ITALY Sabrina Nardi, Cittadinanzattiva the Vienna Medical University Professor Guido Fanelli, (Title/Affiliation tbc) Dr Beverly Collett, Consultant in Pain Management Korinna Pawloff, Vienna Nursing and Patient Advocacy & Anaesthesia, Leicester Royal Infirmary NHS Trust Marcel Kuin, Kuin Zorgmanagement UK Chair of the Chronic Pain Policy Coalition (CPPC) Professor Steven Simoens, Associate Professor, Research Centre Riet van der Heide, Dutch Breast Cancer Association (BVN) for Pharmaceutical Care and Pharmaco-economics, University of HOLLAND Professor Mart van de Laar, Professor of Rheumatology, Medisch Mrs Andrea Fischer BELGIUM Leuven Spectrum Twente Independent Consultant, Former Federal Minister of Mr Johan Tourné, National Secretary, Ziekenzorg cm vzw GERMANY Health, Germany Mr Dominique Michelet, Lawyer and Political Officer for the Per Egil Haavik, Consultant MD, Head of The Pain Clinic, Humanist Democratic Centre, Maison des Parlementraires Stavanger University Hospital Dr Volker Herrmann NORWAY Professor Harald Breivik, Professor of Anaesthesiology, VP CNS and Pain European Marketing, Pfizer Ms Liisa Mikkonen, Chair of the Finnish Pain Association Rikshospitalet, University of Oslo EUROPE Dr Minerva Krohn, Development Director for general medicine in Professor Frank Huygen FINLAND Terveystalo, member of the Helsinki City Council Dr Pedro Saramango Goncaives, Centre for Health Economics, Anaesthesiologist and Head of Erasmus Dr Anne Santalahti, Medical Director for primary health care in Alcuin ‘A’ Block, University of York HOLLAND MC Pain Centre, Rotterdam the City of Turku PORTUGAL Prof Jose Manuel Castro-Lopes, Institute of Histology and Embryology, Faculty of Medicine of the University of Porto Professor Thomas Tölle Matilde Crespo, Association Francophone pour Vaincre les Dr Jose Manuel Soares Malherio Romao, Chronic Pain Unit Neurologist and Psychologist at the Department of Douleurs (AVFD) of Hospital de Santo Antonio; President of the Portuguese GERMANY Neurology, Technische Universität München FRANCE Professor Alain Serrie, Department Head at Lariboisière Hospital Association for the Study of Pain in Paris Ms Maria da Luz Macario Paiva, National Association of Professor Paul Trueman Dr Françoise Laroche, Rheumatologist and Hospital Practitioner Rheumatoid Arthritis Patients, (ANDAR) Professor of Health Economics, Brunel University at Saint-Antoine Hospital in Paris UK Laurence Carton, Association française de lutte antirhumatismale Professor Josep Darba, Department of Economics, University of Professor Giustino Varrassi, President of the European (AFLAR) Barcelona Federation of IASP Chapters (EFIC), Professor and SPAIN Dr Ana Miquel, Conserjera de Sanidad de la Comunidad de ITALY Chairman, Department of Anaesthesiology and Pain Mr Harry Kletzko, German Pain League Madrid Medicine, L’Aquila University, Medical School, Italy Professor Thomas Kohlmann, Head of the Department “Methods Dr Alfredo Perucho, Ramon y Cajal University Hospital GERMANY of Community Medicine” at the Medical Faculty of the University Antonio Torralba, Coordinadora Nacional de Artiritis Professor Pablo Vázquez, Executive Director, Applied of Greifswald Economics Studies Foundation (FEDEA) Dr Reinhard Sittl, Chief Physician at the Pain Centre of the Jan Bagge, Swedish Rheumatology Association SPAIN University Hospital of Erlangen Anders Gustavsson, Associate Director, I3 Innovus Dr Kees Vos SWEDEN Professor Jan-Rickard Norrefalk, Senior Consultant Physician, Primary Care Physician, Spijkenisse and Department of Professor Dimitrios Kouvelas, Professor of Pharmacology and Department of Clinical Sciences Karoliska Institutet, Division of HOLLAND General Practice, Erasmus University, Rotterdam Clinical Pharmacology, School of Medicine of Aristotle University Rehabilitation Medicine, Danderyd Hospital GREECE of Thessaloniki Professor Athina Vadalouka, Assistant Professor of Anaesthesia, Professor Jules Desmules, Associate Professor of Clinical Pain Relief and Palliative Care, University of Athens and President Pharnacology, Department of Anesthesiology Pharmacology & of the Hellenic Society of Palliative and Symptomatic Care of SWITERLAND Intensive Care, University Hospitals, Geneva Cancer and Non Cancer Patients Professor Eli Alon, Professor of Anesthesiology, University of Dr Kostas Athanasakis, Research Fellow of the Department of Zurich, Swiss Society for the Study of Pain Health Economics, National School of Public Health Mr Ian Semmons, Chairman, Action on Pain Mr Michael Bohill, Irish Chronic Pain Association Mr Neil Betteridge, Chief Executive, Arthritis Care and Vice Dr Liam Conroy, Director of the Department of Pain Medicine, UK President of the European League Against Rheumatism (EULAR) IRELAND Mercy University Hospital, Cork John Church, CEO, Arthritis Ireland Can You Feel My Pain is a Europe-wide coalition campaign European Parkinsons Coordinadora designed and implemented by patient advocacy groups across Disease associations Nacional de Artistis Europe while raising awareness of Chronic Pain and providing a channel for ‘real-life’ patient stories for inclusion within the Pain Annelies Vanbrabant, De Viaamse Pijnliga Proposal. Harry Kletzko, Dutsche Schmerzliga The Pain Proposal Steering Committee would like to thank the Melody Ross, Cittadinanzattiva members of patient advocacy group advisory board who worked in Ditte Kuijpens, Borstkanker Veriniging Netherlands The Pain Proposal Consensus Report has been developed by a range of European experts in the field of chronic pain in partnership with Pfizer. All partnership with Pfizer to develop and implement the Can You Feel Martin Aebi, VSP Vereinigung Schweizer Schmerzpatienten the content in this report has been informed by the opinions and guidance of The Pain Proposal Steering and Executive Committees. The report My Pain, European health awareness campaign. Liisa Mikkonen, [insert organisation] offers a consensus of opinion on chronic pain and should not be interpreted as a direct representation of the views of any one party. 2 3 Foreword Contents Introducing The Pain Proposal Foreword: Introducing the Pain Proposal 5 According to recent surveys, one in five Europeans (19%) are of Europeans today. The surveys also sought to establish how pain estimated to suffer from chronic pain according to past surveys. management services are performing to better inform our calls for Executive Summary 6 Many people will find that a shocking statistic, however, for action. The results reveal the issues many people face in receiving a individuals with chronic pain the reality is more than shocking. diagnosis or adequate management of their chronic pain and the Chronic pain is a terrible burden that many are left to carry alone, resultant impact on their ability to work and also their productivity Chronic Pain 8-9 day in and day out. We cannot feel their pain but we can empathise whilst at work. • Chronic Pain affects 1 in 5 adults in Europe and recognise the impact that the consequences of chronic pain • The Complexities of Diagnosing Pain have on society and on the wider economy. Although attempts Currently, access to pain management services is highly inconsistent in Europe, both within and across nations. Moreover, • Chronic Pain Origins have been made to address the problem, so far they have only achieved mixed success. available health services for pain differ markedly in the type of care they offer. We believe a new minimum standard of care is required Living with Chronic Pain 10-15 Members of the Steering