Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program

Lyne Lalonde,1–4 Manon Choinière,3,5 Élisabeth Martin,2,3 Djamal Berbiche,2,3 Sylvie Perreault,1,6 David Lussier7–91Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada; 2Équipe de recherche en soins de premi&am...

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Main Authors: Lalonde L, Choinière M, Martin É, Berbiche D, Perreault S, Lussier D
Format: Article
Language:English
Published: Dove Medical Press 2014-07-01
Series:Journal of Pain Research
Online Access:http://www.dovepress.com/costs-of-moderate-to-severe-chronic-pain-in-primary-care-patients-ndas-a17499
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spelling doaj-871c2cf71ff8403a9e0a552eddba3eda2020-11-24T21:53:34ZengDove Medical PressJournal of Pain Research1178-70902014-07-012014default38940317499Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD ProgramLalonde LChoinière MMartin ÉBerbiche DPerreault SLussier D Lyne Lalonde,1–4 Manon Choinière,3,5 Élisabeth Martin,2,3 Djamal Berbiche,2,3 Sylvie Perreault,1,6 David Lussier7–91Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada; 2Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada; 3Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; 4Sanofi Aventis Endowment Chair in Ambulatory Pharmaceutical Care, Université de Montréal and Centre de santé et de services sociaux de Laval, QC, Canada; 5Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; 6Sanofi Aventis Endowment Research Chair in Optimal Drug Use, Université de Montréal, Montreal, QC, Canada; 7Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada; 8Division of Geriatric Medicine and Alan-Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; 9Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, CanadaBackground: The economic burden of chronic noncancer pain (CNCP) remains insufficiently documented in primary care.Purpose: To evaluate the annual direct health care costs and productivity costs associated with moderate to severe CNCP in primary care patients taking into account their pain disability.Materials and methods: Patients reporting noncancer pain for at least 6 months, at a pain intensity of 4 or more on a 0 (no pain) to 10 (worst possible pain) intensity scale, and at a frequency of at least 2 days a week, were recruited from community pharmacies. Patients' characteristics, health care utilization, and productivity losses (absenteeism and presenteeism) were documented using administrative databases, pharmacies' renewal charts, telephone, and self-administered questionnaires. Patients were stratified by tertile of pain disability measured by the Brief Pain Inventory questionnaire.Results: Patients (number =483) were, on average, 59 years old, mainly women (67.5%), and suffered from CNCP for a mean of 12 years at an average pain intensity of 6.5±1.9. The annual direct health care costs and productivity costs averaged CAD $9,565 (±$13,993) and CAD $7,072 (±$11,716), respectively. The use of complementary health care services accounted for almost 50% of the direct health care costs. The mean adjusted total direct health care costs (considering pain-related hospitalizations only) and productivity costs increased with more pain disability: low disability, CAD $12,118; moderate, CAD $18,278; and severe, CAD $19,216; P=0.001.Conclusion: The economic burden of CNCP is substantial and increases with the level of pain disability, which suggests the need for and potential benefits of improving CNCP management through specific and adapted treatment plans targeting the impact of pain on daily functioning.Keywords: noncancer chronic pain, primary care, cohort study, direct health care costs, productivity costs, Brief Pain Inventoryhttp://www.dovepress.com/costs-of-moderate-to-severe-chronic-pain-in-primary-care-patients-ndas-a17499
collection DOAJ
language English
format Article
sources DOAJ
author Lalonde L
Choinière M
Martin É
Berbiche D
Perreault S
Lussier D
spellingShingle Lalonde L
Choinière M
Martin É
Berbiche D
Perreault S
Lussier D
Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program
Journal of Pain Research
author_facet Lalonde L
Choinière M
Martin É
Berbiche D
Perreault S
Lussier D
author_sort Lalonde L
title Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program
title_short Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program
title_full Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program
title_fullStr Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program
title_full_unstemmed Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program
title_sort costs of moderate to severe chronic pain in primary care patients – a study of the accord program
publisher Dove Medical Press
series Journal of Pain Research
issn 1178-7090
publishDate 2014-07-01
description Lyne Lalonde,1–4 Manon Choinière,3,5 Élisabeth Martin,2,3 Djamal Berbiche,2,3 Sylvie Perreault,1,6 David Lussier7–91Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada; 2Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada; 3Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; 4Sanofi Aventis Endowment Chair in Ambulatory Pharmaceutical Care, Université de Montréal and Centre de santé et de services sociaux de Laval, QC, Canada; 5Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; 6Sanofi Aventis Endowment Research Chair in Optimal Drug Use, Université de Montréal, Montreal, QC, Canada; 7Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada; 8Division of Geriatric Medicine and Alan-Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; 9Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, CanadaBackground: The economic burden of chronic noncancer pain (CNCP) remains insufficiently documented in primary care.Purpose: To evaluate the annual direct health care costs and productivity costs associated with moderate to severe CNCP in primary care patients taking into account their pain disability.Materials and methods: Patients reporting noncancer pain for at least 6 months, at a pain intensity of 4 or more on a 0 (no pain) to 10 (worst possible pain) intensity scale, and at a frequency of at least 2 days a week, were recruited from community pharmacies. Patients' characteristics, health care utilization, and productivity losses (absenteeism and presenteeism) were documented using administrative databases, pharmacies' renewal charts, telephone, and self-administered questionnaires. Patients were stratified by tertile of pain disability measured by the Brief Pain Inventory questionnaire.Results: Patients (number =483) were, on average, 59 years old, mainly women (67.5%), and suffered from CNCP for a mean of 12 years at an average pain intensity of 6.5±1.9. The annual direct health care costs and productivity costs averaged CAD $9,565 (±$13,993) and CAD $7,072 (±$11,716), respectively. The use of complementary health care services accounted for almost 50% of the direct health care costs. The mean adjusted total direct health care costs (considering pain-related hospitalizations only) and productivity costs increased with more pain disability: low disability, CAD $12,118; moderate, CAD $18,278; and severe, CAD $19,216; P=0.001.Conclusion: The economic burden of CNCP is substantial and increases with the level of pain disability, which suggests the need for and potential benefits of improving CNCP management through specific and adapted treatment plans targeting the impact of pain on daily functioning.Keywords: noncancer chronic pain, primary care, cohort study, direct health care costs, productivity costs, Brief Pain Inventory
url http://www.dovepress.com/costs-of-moderate-to-severe-chronic-pain-in-primary-care-patients-ndas-a17499
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