Chronic pain in primary care. German figures from 1991 and 2006.
BACKGROUND
Until now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation of patients suffering from pain. How many patients visit an outpatient clinic because of the symptom of pain? These data were compared with data from a similar study in 1991, to investigate whether improvements had been achieved.


METHODS
A total of 1201 consecutive patients visiting outpatient clinics were surveyed in six practices in the western part of Germany on randomly selected days by means of questionnaires. Topics were the point prevalence of pain and the period prevalence of chronic pain, its characteristics and its impact on daily life, as well as data on previous therapies for pain. A retrospective comparison was made with the data from a similar study with same design surveying 900 patients that took place in five practices during 1991.


RESULTS
In 2006, pain was the main reason for consulting a doctor in 42.5% of all patients (1991: 50.3%). Of all respondents, 62% suffered from pain on the particular day of the consultation, and 40% reported that they had been suffering from pain for more than six months (1991: 36.4%). As many as 88.3% of patients with chronic pain reported a negative impact on their daily life due to this pain (1991: 68%), and 88.1% reported impairment of their working life because of chronic pain (1991: 59.1%).


CONCLUSIONS
Pain, and chronic pain in particular, is a central problem in primary care. Over the last 15 years, the number of patients suffering from chronic pain has not decreased. In nearly half of all cases, pain is still the reason for health care utilisation in outpatient clinics. Pain represents a major primary health care problem with enormous impact on public health. Improvements can only be achieved by improving the quality of health care at the primary care level.
Friessem
Christine H
CH
Department of Anaesthesiology, Intensive Care, Palliative Care and Pain Medicine BG-Universitätsklinikum Bergmannsheil - University Hospital, Ruhr-University, Bochum, Germany. friessem@anaesthesia.de
Willweber-Strumpf
Anne
A
Zenz
Michael W
MW
D002908:Chronic Disease; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D011320:Primary Health Care; D011795:Surveys and Questionnaires
Schmerz. 1991 Dec;5(4):208-13
18415173
Pain. 1998 Sep;77(3):231-239
9808348
Eur J Pain. 2006 May;10(4):287-333
16095934
J Gen Intern Med. 2006 Jun;21(6):652-5
16808752
Pain. 2001 Jan;89(2-3):127-34
11166468
Pain Pract. 2004 Sep;4(3):179-81
17173599
Am Fam Physician. 2007 Apr 15;75(8):1181-8
17477101
Schmerz. 2001 Apr;15(2):92-8
11810338
J Rheumatol. 2000 Jun;27(6):1521-5
10852282
JAMA. 1998 Jul 8;280(2):147-51
9669787
J Rheumatol. 2002 Apr;29(4):818-25
11950027
J Epidemiol Community Health. 1999 Aug;53(8):503-9
10562870
Schmerz. 2002 Feb;16(1):22-33
11845338
Pain Med. 2008 Mar;9(2):166-74
18298699
Pain. 1989 May;37(2):215-222
2748195
Nervenarzt. 2001 Dec;72(12):897-906
11789433
Z Arztl Fortbild Qualitatssich. 1998 Jan;92(1):65-9
9553216
Int J Technol Assess Health Care. 2000 Summer;16(3):929-43
11028149
Pain. 2008 Aug 31;138(2):267-276
18226858
JAMA. 2003 Nov 12;290(18):2443-54
14612481
Schmerz. 1999 Dec 13;13(6):375-84
12799913
Rheumatology (Oxford). 2005 Jul;44(7):890-5
15784630
Schmerz. 2004 Feb;18(1):10-6
14872325
Pain Manag Nurs. 2006 Mar;7(1):2-11
16490731
Pain. 2002 Sep;99(1-2):299-307
12237208
Eur J Pain. 2002;6(5):375-85
12160512
Pain. 2005 Dec 15;119(1-3):183-190
16297552
Br J Gen Pract. 1992 Nov;42(364):462-4
1472392
Fam Pract. 2001 Jun;18(3):292-9
11356737
Pain. 2004 Sep;111(1-2):51-8
15327808
Pain Res Manag. 2002 Winter;7(4):179-84
12518174
Pain. 2001 Jan;89(2-3):175-80
11166473
Expert Rev Neurother. 2007 Jun;7(6):627-35
17563246
Anaesthesist. 1993 Mar;42(3):169-74
8480904
Psychosom Med. 1991 Jan-Feb;53(1):61-79
2011651
Curr Opin Rheumatol. 2002 Mar;14(2):104-8
11845013
Lancet. 1999 Oct 9;354(9186):1248-52
10520633
Eur J Pain. 2002;6(2):133-40
11900473
Curr Med Res Opin. 2003;19(8):703-6
14687440
Isr Med Assoc J. 2008 Oct;10(10):676-80
19009944
Pain. 1988 Feb;32(2):173-183
3362555
Pain. 2003 May;103(1-2):41-7
12749957
BMC Musculoskelet Disord. 2005 Jul 21;6:42
16042761
Schmerz. 2008 Aug;22(4):424-32
18437429
Pain. 2003 Dec;106(3):221-228
14659505
Eur J Pain. 2009 Mar;13(3):287-92
18547844
Schmerz. 2000 Apr;14(2):84-91
12800044
BMC Public Health. 2008 Jul 21;8:246
18638419
Eur J Pain. 2007 Jul;11(5):487-9
17433738