title: The costs and consequences of adequately managed chronic non-cancer pain and chronic neuropathic pain.
abstract: BACKGROUND
  Chronic pain is distressing for patients and a burden on healthcare systems and society. Recent research demonstrates different aspects of the negative impact of chronic pain and the positive impact of successful treatment, making an overview of the costs and consequences of chronic pain appropriate.
  
  
  OBJECTIVE
  To examine recent literature on chronic noncancer and neuropathic pain prevalence, impact on quality and quantity of life, societal and healthcare costs, and impact of successful therapy.
  
  
  METHODS
  Systematic reviews (1999 to February 2012) following PRISMA guidelines were conducted to identify studies reporting appropriate outcomes.
  
  
  RESULTS
  Chronic pain has a weighted average prevalence in adults of 20%; 7% have neuropathic pain, and 7% have severe pain. Chronic pain impeded activities of daily living, work and work efficiency, and reduced quality and quantity of life. Effective pain therapy (pain intensity reduction of at least 50%) resulted in consistent improvements in fatigue, sleep, depression, quality of life, and work.
  
  
  CONCLUSIONS
  Strenuous efforts should be put into obtaining good levels of pain relief for people in chronic pain, including the opportunity for multiple drug switching, using reliable, validated, and relatively easily applied patient-centered outcomes. Detailed, thoughtful and informed decision analytic policy modeling would help understand the key elements in organizational change or service reengineering to plan the optimum pain management strategy to maximize pain relief and its stream of benefits against budgetary and other constraints. This paper contains the information on which such models can be based.
authors: Pain Research and Nuffield Division of Anaesthetics, University of Oxford, The Churchill, Oxford, U.K.
authors: R
authors: R
authors: Andrew
authors: Sheena
authors: S
authors: Derry
authors: Rod S
authors: RS
authors: Taylor
authors: Sebastian
authors: S
authors: Straube
authors: Ceri J
authors: CJ
authors: Phillips
mesh_terms: D059350:Chronic Pain / Q000191:economics* / Q000628:therapy*; D017048:Health Care Costs; D006801:Humans; D009437:Neuralgia / Q000191:economics* / Q000628:therapy*; D059408:Pain Management / Q000191:economics* / Q000379:methods
keywords: evidence-based medicine; health-related quality of life; healthcare costs; neuropathic pain; noncancer pain; pain disorder; pain treatment; systematic review