Prevalence, causes, severity, impact, and management of chronic pain in Australian general practice patients

Abstract

Objective: To determine the prevalence of chronic pain, its causes, severity, management, impact on sleep, mood and activity levels, and general practitioner (GP) and patient satisfaction with pain management. Design: A subset of 197 GPs and 5,793 patients from the BEACH program, a continuous, national cross-sectional survey of Australian general practice. Results: The prevalence of chronic pain was 19.2% (95% confidence interval: 17.4-21.0) (N=1,113). The most commonly reported causal conditions were osteoarthritis (48.1%) and back problems (29.4%). For pain severity (using Von Korff's pain grades), 25.2% were at Grade I (lowest); 37.1% were at Grade II; 28.3% at Grade III; and 9.4% at Grade IV (highest). Medication was used for pain management by 86.1% of patients, and one third also used nonpharmacological managements. One third of patients were taking opioids, most commonly those at the highest pain severity grades. On "Live Better with Pain Log" scale, the impact of pain was similar across activity (mean=4.0), sleep (mean=4.8), and mood (mean=4.8). On a scale of 1 (highest) to 5 (lowest), GPs' satisfaction (mean=2.5) was highly correlated (r=0.7) with patients' satisfaction (mean=2.6) with pain management. Conclusions: Chronic pain impairs patient quality of life, and is a public health burden. This study provides a national overview of the prevalence, causes, severity, management and impact of chronic pain in Australian general practice patients, and the parity between GP and patient satisfaction with pain management. © 2013 American Academy of Pain Medicine.