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"Improving management of severe chronic pain
European pain experts join in CHANGE PAIN campaign"
Aachen, 21 August 2009. Severe chronic pain is multifactorial in nature and often insufficiently managed. Many patients are unidentified or do not receive appropriate treatment, but even with treatment patients often find themselves in a vicious circle of insufficient analgesia and debilitating side effects associated with their medication. This situation contributes to low compliance and high rates of treatment discontinuation among chronic pain patients. In order to improve pain management Grünenthal has initiated the CHANGE PAIN campaign, which recently gathered experts from across Europe in Brussels to discuss the unmet medical needs in severe chronic pain management. Major objectives of the campaign will be to improve education of physicians and communication between physicians and patients as these are key factors for better management of severe chronic pain.
"Across Europe we can see huge differences in the use of analgesics, and we can see a lack of knowledge among physicians not specialised in pain", explained Professor Giustino Varrassi, President of the European Federation of Chapters of the International Association for the Study of Pain (EFIC). "A better understanding of the pain pathways and the mechanisms of pain will enable them to treat their pain patients more rational." Professor Giustino Varrassi is chairing the CHANGE PAIN campaign with Dr. Gerhard H. H. Mueller-Schwefe.
An additional problem is the lack of communication between physicians and patients. "It is very important that physicians and patients communicate, as this is the only way to assess the level of pain a patient is experiencing", said Dr. Gerhard H. H. Mueller-Schwefe, President of the German Pain Association (DGS). "By talking to the patient we can set individual treatment objectives, educate him about the therapy and manage his expectations."
Side effects of current pharmacological treatment options often limit the effective analgesic dosage of the drugs used. Patients receiving strong opioids are particularly susceptible and often find themselves in a vicious circle of insufficient analgesia and debilitating side effects: If a patient experiences insufficient analgesia, the dose of the analgesic is increased in order to achieve sufficient pain relief, but an increased dose can also increase side effects. If a patient suffers from a high level of side effects, the dose is reduced and this can again lead to insufficient analgesia. This cycle often results in low patient compliance and in many cases treatment discontinuation.1,2
Another challenge in chronic pain management is the underlying pathophysiology, which can be different from patient to patient. When a neuropathic component is present, the pain is often more severe and more difficult to treat.3 In chronic low back pain it is estimated that only one-third of patients suffer from pure nociceptive pain.4
Therefore it is crucial to identify neuropathic pain symptoms, which is often difficult, and to appropriately treat both pain components of the condition. Current treatment practice is a combination therapy, but this can also lead to an increase in side effects.
These and other topics from the expert discussion will be consolidated in a consensus paper in order to make the findings of the group available to physicians across Europe. The CHANGE PAIN group will further work to generate more insight on the unmet medical needs in severe chronic pain management. Findings of this research will be published in scientific publications and educational material will be developed to improve the knowledge on pain physiology among non-pain specialists.5,6
About CHANGE PAIN
The CHANGE PAIN campaign was initiated by German pain expert Grünenthal to contribute to an improved severe chronic pain management. The campaign is supported by the European Federation of Chapters of the International Association for the Study of Pain (EFIC) and involves pain experts from across Europe. It is chaired by Professor Giustino Varrassi, President of the EFIC and Dr. Gerhard H. H. Mueller-Schwefe, President of the German Pain Association (DGS). Key objectives of CHANGE PAIN are to generate a better understanding of the unmet medical needs in severe chronic pain management, as well as to improve education of physicians and communication between physicians and patients.
About Grünenthal
Grünenthal is an expert in pain therapy and gynaecology and a pioneer in intelligent, user-friendly drug delivery technologies. The company discovers, develops, produces and markets high therapeutic value pharmaceuticals that contribute to patients’ ability to control their own lives. Grünenthal is an independent, family-owned German company with companies in 32 countries all over the world. Founded in 1946, the company employs 1,900 people in Germany and 5,300 worldwide. In 2007, Grünenthal achieved revenues of 846 million Euros.
More information: www.grunenthal.com.
References:
1 Kalso E et al. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain. 2004;112(3):372-380
2 Moore RA, McQuay HJ. Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. Arthritis Research & Therapy. 2005;7: R1046-1051
3 Schmidt CO et al. Modelling the prevalence and costs of back pain with neuropathic components in the general population. European Journal of Pain. 2009, doi:10.1016/j.ejpain.2008.12.003. Epub ahead of print
4 Freynhagen Rainer et al: painDetect: a new screening questionnaire to identify neuropathic components in patients with back pain. Current Medical Research and Opinion. 2006; 22:1911-1920
5 Gilron I et al.Morphine, gabapentin, or their combination for neuropathic pain. New England Journal of Medicine. 2005;352(13):1324-1334.
6 Hanna M et al. Prolonged-release oxycodone enhances the effects of existing gabapentin therapy in painful diabetic neuropathy patients. European Journal of Pain. 2008;12(6):804-813
