Helping pain patients access better care

Dr Arun Bhaskar

President, British Pain Society

People living with chronic or persistent pain see a significant negative impact on their daily life, more needs to be done to make pain management a priority.

In the UK, 8 million adults and around one in five adult Europeans report moderate to severe pain that is disabling, 40% of them reported inadequate management and haven’t had specialist treatment.

People suffering from chronic pain have very low quality of life indicators (EQ-5D) and there had been studies where the baseline scores of patients with chronic pain were considerably lower than those admitted with stroke.

Making pain a priority

Chronic pain patients are twice as likely to visit the GP surgery and five times more likely to attend A&E. In the UK, patients with chronic pain attend nearly 5 million primary care appointments per year. This is attributed to persistent symptoms contributed by poor understanding of the problem, resulting in unnecessary referrals, investigations and ineffective treatments.

Despite affecting a significantly large number of people, pain is not deemed as a priority like cancer or heart disease; hence only a small fraction of the health and social care budget is allocated for managing these patients.

Chronic pain and mental health issues contribute to more than half the sick notes in the UK. People with persistent pain are seven times more likely to quit their job and claim long-term incapacity and disability benefits. Thus, chronic pain is not only a physical and psychological condition, but also an emotional, social, economic and humanitarian issue.

Chronic pain patients are twice as likely to visit the GP surgery and five times more likely to attend A&E.

Learning about pain through life experiences

There is room for optimism. The revised definition by International Association for the Study of Pain acknowledges pain as a personal experience influenced by various factors and a person’s report of an experience as pain should be respected.

It also states that the concept of pain is learnt through life experiences and though it usually serves an adaptive role, it may have adverse effects on function and social and psychological wellbeing.

Improving collaboration in pain care

There are plans to integrate health and social care as well as better collaboration between various specialities and primary care. Hopefully the GIRFT (Get it Right First Time) initiative will ensure that the patients receive appropriate treatment without undue delay.

Until we listen to the patient and devote time and effort in understanding how the pain is affecting them and had negatively impacted on their life, we would be failing to help them. It is also our responsibility to raise awareness, so that adequate funding is allocated to deal with these complex issues.