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Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Chronic pain in primary care. German figures from 1991 and 2006

Authors: Christine H Frießem, Anne Willweber-Strumpf, Michael W Zenz

Published in: BMC Public Health | Issue 1/2009

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Abstract

Background

Until now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation of patients suffering from pain. How many patients visit an outpatient clinic because of the symptom of pain? These data were compared with data from a similar study in 1991, to investigate whether improvements had been achieved.

Methods

A total of 1201 consecutive patients visiting outpatient clinics were surveyed in six practices in the western part of Germany on randomly selected days by means of questionnaires. Topics were the point prevalence of pain and the period prevalence of chronic pain, its characteristics and its impact on daily life, as well as data on previous therapies for pain. A retrospective comparison was made with the data from a similar study with same design surveying 900 patients that took place in five practices during 1991.

Results

In 2006, pain was the main reason for consulting a doctor in 42.5% of all patients (1991: 50.3%). Of all respondents, 62% suffered from pain on the particular day of the consultation, and 40% reported that they had been suffering from pain for more than six months (1991: 36.4%). As many as 88.3% of patients with chronic pain reported a negative impact on their daily life due to this pain (1991: 68%), and 88.1% reported impairment of their working life because of chronic pain (1991: 59.1%).

Conclusion

Pain, and chronic pain in particular, is a central problem in primary care. Over the last 15 years, the number of patients suffering from chronic pain has not decreased. In nearly half of all cases, pain is still the reason for health care utilisation in outpatient clinics. Pain represents a major primary health care problem with enormous impact on public health. Improvements can only be achieved by improving the quality of health care at the primary care level.
Appendix
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Literature
2.
go back to reference Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D: Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006, 10: 287-333. 10.1016/j.ejpain.2005.06.009.CrossRefPubMed Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D: Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006, 10: 287-333. 10.1016/j.ejpain.2005.06.009.CrossRefPubMed
3.
go back to reference Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA: The epidemiology of chronic pain in the community. Lancet. 1999, 354: 1248-1252. 10.1016/S0140-6736(99)03057-3.CrossRefPubMed Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA: The epidemiology of chronic pain in the community. Lancet. 1999, 354: 1248-1252. 10.1016/S0140-6736(99)03057-3.CrossRefPubMed
4.
go back to reference Nickel R, Raspe HH: Chronic pain: epidemiology and health care utilization. Nervenarzt. 2001, 72: 897-906. 10.1007/s001150170001.CrossRefPubMed Nickel R, Raspe HH: Chronic pain: epidemiology and health care utilization. Nervenarzt. 2001, 72: 897-906. 10.1007/s001150170001.CrossRefPubMed
5.
go back to reference Verhaak PF, Kerssens JJ, Dekker J, Sorbi MJ, Bensing JM: Prevalence of chronic benign pain disorder among adults: a review of the literature. Pain. 1998, 77: 231-239. 10.1016/S0304-3959(98)00117-1.CrossRefPubMed Verhaak PF, Kerssens JJ, Dekker J, Sorbi MJ, Bensing JM: Prevalence of chronic benign pain disorder among adults: a review of the literature. Pain. 1998, 77: 231-239. 10.1016/S0304-3959(98)00117-1.CrossRefPubMed
6.
go back to reference Neville A, Peleg R, Singer Y, Sherf M, Shvartzman P: Chronic pain: a population-based study. Isr Med Assoc J. 2008, 10: 676-680.PubMed Neville A, Peleg R, Singer Y, Sherf M, Shvartzman P: Chronic pain: a population-based study. Isr Med Assoc J. 2008, 10: 676-680.PubMed
7.
go back to reference Gureje O, Von Korff M, Simon GE, Gater R: Persistent pain and well-being: a World Health Organization Study in Primary Care. Jama. 1998, 280: 147-151. 10.1001/jama.280.2.147.CrossRefPubMed Gureje O, Von Korff M, Simon GE, Gater R: Persistent pain and well-being: a World Health Organization Study in Primary Care. Jama. 1998, 280: 147-151. 10.1001/jama.280.2.147.CrossRefPubMed
8.
go back to reference Hasselstrom J, Liu-Palmgren J, Rasjo-Wraak G: Prevalence of pain in general practice. Eur J Pain. 2002, 6: 375-385. 10.1016/S1090-3801(02)00025-3.CrossRefPubMed Hasselstrom J, Liu-Palmgren J, Rasjo-Wraak G: Prevalence of pain in general practice. Eur J Pain. 2002, 6: 375-385. 10.1016/S1090-3801(02)00025-3.CrossRefPubMed
9.
go back to reference Willweber-Strumpf A, Zenz M, Bartz D: Epidemiology of Chronic pain – an investigation in 5 medical practices. Schmerz. 2000, 14: 84-91. 10.1007/s004820050226.CrossRefPubMed Willweber-Strumpf A, Zenz M, Bartz D: Epidemiology of Chronic pain – an investigation in 5 medical practices. Schmerz. 2000, 14: 84-91. 10.1007/s004820050226.CrossRefPubMed
10.
go back to reference Catala E, Reig E, Artes M, Aliaga L, Lopez JS, Segu JL: Prevalence of pain in the Spanish population: telephone survey in 5000 homes. Eur J Pain. 2002, 6: 133-140. 10.1053/eujp.2001.0310.CrossRefPubMed Catala E, Reig E, Artes M, Aliaga L, Lopez JS, Segu JL: Prevalence of pain in the Spanish population: telephone survey in 5000 homes. Eur J Pain. 2002, 6: 133-140. 10.1053/eujp.2001.0310.CrossRefPubMed
11.
go back to reference Von Korff M, Wagner EH, Dworkin SF: Chronic pain and use of ambulatory health care. Psychosom Med. 1991, 53: 61-79.CrossRefPubMed Von Korff M, Wagner EH, Dworkin SF: Chronic pain and use of ambulatory health care. Psychosom Med. 1991, 53: 61-79.CrossRefPubMed
12.
go back to reference Bartz D: Chronische Schmerzen im hausärztlichen Bereich: Eine Befragung in fünf Bochumer Facharztpraxen. PhD thesis. 1999, Ruhr-University Bochum, Faculty of medicine Bartz D: Chronische Schmerzen im hausärztlichen Bereich: Eine Befragung in fünf Bochumer Facharztpraxen. PhD thesis. 1999, Ruhr-University Bochum, Faculty of medicine
13.
go back to reference Von Korff M, Dworkin SF, Resche LL, Kruger A: An epidemiologic comparison of pain complaints. Pain. 1988, 32: 173-183. 10.1016/0304-3959(88)90066-8.CrossRefPubMed Von Korff M, Dworkin SF, Resche LL, Kruger A: An epidemiologic comparison of pain complaints. Pain. 1988, 32: 173-183. 10.1016/0304-3959(88)90066-8.CrossRefPubMed
14.
go back to reference Potter RG, Jones JM: The evolution of chronic pain among patients with musculoskeletal problems: a pilot study in primary care. Br J Gen Pract. 1992, 42: 462-464.PubMedPubMedCentral Potter RG, Jones JM: The evolution of chronic pain among patients with musculoskeletal problems: a pilot study in primary care. Br J Gen Pract. 1992, 42: 462-464.PubMedPubMedCentral
15.
go back to reference Eriksen J, Jensen MK, Sjogren P, Ekholm O, Rasmussen NK: Epidemiology of chronic non-malignant pain in Denmark. Pain. 2003, 106: 221-228. 10.1016/S0304-3959(03)00225-2.CrossRefPubMed Eriksen J, Jensen MK, Sjogren P, Ekholm O, Rasmussen NK: Epidemiology of chronic non-malignant pain in Denmark. Pain. 2003, 106: 221-228. 10.1016/S0304-3959(03)00225-2.CrossRefPubMed
16.
go back to reference Brattberg G, Thorslund M, Wikman A: The prevalence of pain in a general population. The results of a postal survey in a county of Sweden. Pain. 1989, 37: 215-222. 10.1016/0304-3959(89)90133-4.CrossRefPubMed Brattberg G, Thorslund M, Wikman A: The prevalence of pain in a general population. The results of a postal survey in a county of Sweden. Pain. 1989, 37: 215-222. 10.1016/0304-3959(89)90133-4.CrossRefPubMed
17.
go back to reference Moulin DE, Clark AJ, Speechley M, Morley-Forster PK: Chronic pain in Canada – prevalence, treatment, impact and the role of opioid analgesia. Pain Res Manag. 2002, 7: 179-184.CrossRefPubMed Moulin DE, Clark AJ, Speechley M, Morley-Forster PK: Chronic pain in Canada – prevalence, treatment, impact and the role of opioid analgesia. Pain Res Manag. 2002, 7: 179-184.CrossRefPubMed
18.
go back to reference Kayser H, Thoma R, Mertens E, Sorgatz H, Zenz M, Lindena G: Structure of outpatient pain therapy in Germany. Results of a survey. Schmerz. 2008, 22: 424-432. 10.1007/s00482-008-0650-z.CrossRefPubMed Kayser H, Thoma R, Mertens E, Sorgatz H, Zenz M, Lindena G: Structure of outpatient pain therapy in Germany. Results of a survey. Schmerz. 2008, 22: 424-432. 10.1007/s00482-008-0650-z.CrossRefPubMed
19.
go back to reference Lindena G, Hildebrandt J, Diener HC, Schops P, Maier C: Pain treatment facilities in Germany. Ambulatory, day care and inpatient facilities for patients with chronic pain. Schmerz. 2004, 18: 10-16. 10.1007/s00482-003-0249-3.CrossRefPubMed Lindena G, Hildebrandt J, Diener HC, Schops P, Maier C: Pain treatment facilities in Germany. Ambulatory, day care and inpatient facilities for patients with chronic pain. Schmerz. 2004, 18: 10-16. 10.1007/s00482-003-0249-3.CrossRefPubMed
20.
go back to reference Mäntyselkä P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, Halonen P, Takala J: Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001, 89: 175-180. 10.1016/S0304-3959(00)00361-4.CrossRefPubMed Mäntyselkä P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, Halonen P, Takala J: Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001, 89: 175-180. 10.1016/S0304-3959(00)00361-4.CrossRefPubMed
21.
go back to reference Upshur CC, Luckmann RS, Savageau JA: Primary care provider concerns about management of chronic pain in community clinic populations. J Gen Intern Med. 2006, 21: 652-655. 10.1111/j.1525-1497.2006.00412.x.CrossRefPubMedPubMedCentral Upshur CC, Luckmann RS, Savageau JA: Primary care provider concerns about management of chronic pain in community clinic populations. J Gen Intern Med. 2006, 21: 652-655. 10.1111/j.1525-1497.2006.00412.x.CrossRefPubMedPubMedCentral
22.
go back to reference Sjogren P, Ekholm O, Peuckmann V, Gronbaek M: Epidemiology of chronic pain in Denmark: an update. Eur J Pain. 2009, 13: 287-292. 10.1016/j.ejpain.2008.04.007.CrossRefPubMed Sjogren P, Ekholm O, Peuckmann V, Gronbaek M: Epidemiology of chronic pain in Denmark: an update. Eur J Pain. 2009, 13: 287-292. 10.1016/j.ejpain.2008.04.007.CrossRefPubMed
23.
go back to reference Harkness EF, Macfarlane GJ, Silman AJ, McBeth J: Is musculoskeletal pain more common now than 40 years ago?: Two population-based cross-sectional studies. Rheumatology (Oxford). 2005, 44: 890-895. 10.1093/rheumatology/keh599.CrossRef Harkness EF, Macfarlane GJ, Silman AJ, McBeth J: Is musculoskeletal pain more common now than 40 years ago?: Two population-based cross-sectional studies. Rheumatology (Oxford). 2005, 44: 890-895. 10.1093/rheumatology/keh599.CrossRef
24.
go back to reference Gibson SJ: IASP global year against pain in older persons: highlighting the current status and future perspectives in geriatric pain. Expert Rev Neurother. 2007, 7: 627-635. 10.1586/14737175.7.6.627.CrossRefPubMed Gibson SJ: IASP global year against pain in older persons: highlighting the current status and future perspectives in geriatric pain. Expert Rev Neurother. 2007, 7: 627-635. 10.1586/14737175.7.6.627.CrossRefPubMed
28.
go back to reference Niv D, Devor M: Chronic pain as a disease in its own right. Pain Pract. 2004, 4: 179-181. 10.1111/j.1533-2500.2004.04301.x.CrossRefPubMed Niv D, Devor M: Chronic pain as a disease in its own right. Pain Pract. 2004, 4: 179-181. 10.1111/j.1533-2500.2004.04301.x.CrossRefPubMed
29.
go back to reference Bellach BM, Ellert U, Radoschewski : Epidemiologie des Schmerzes- Ergebnisse des Bundes-Gesundheitssurveys 1998. Gesundheitsforsch- Gesundheitsschutz. 2000, 43: 424-431. 10.1007/s001030070048.CrossRef Bellach BM, Ellert U, Radoschewski : Epidemiologie des Schmerzes- Ergebnisse des Bundes-Gesundheitssurveys 1998. Gesundheitsforsch- Gesundheitsschutz. 2000, 43: 424-431. 10.1007/s001030070048.CrossRef
30.
go back to reference Kohlmann T: Pain complaints among inhabitants of Lubeck: results of a population-based epidemiologic study. Schmerz. 1991, 5: 208-213. 10.1007/BF02527799.CrossRefPubMed Kohlmann T: Pain complaints among inhabitants of Lubeck: results of a population-based epidemiologic study. Schmerz. 1991, 5: 208-213. 10.1007/BF02527799.CrossRefPubMed
31.
go back to reference Kinkade S: Evaluation and treatment of acute low back pain. Am Fam Physician. 2007, 75: 1181-1188.PubMed Kinkade S: Evaluation and treatment of acute low back pain. Am Fam Physician. 2007, 75: 1181-1188.PubMed
32.
go back to reference Uhlig T, Hagen KB, Kvien TK: Why do patients with chronic musculoskeletal disorders consult their primary care physicians?. Curr Opin Rheumatol. 2002, 14: 104-108. 10.1097/00002281-200203000-00005.CrossRefPubMed Uhlig T, Hagen KB, Kvien TK: Why do patients with chronic musculoskeletal disorders consult their primary care physicians?. Curr Opin Rheumatol. 2002, 14: 104-108. 10.1097/00002281-200203000-00005.CrossRefPubMed
33.
go back to reference Schumacher J, Brähler E: The prevalence of pain in the German population: results of population-based studies with the Giessen Subjective Complaints List (Giessener Beschwerdebogen GBB). Schmerz. 1999, 13: 375-384. 10.1007/s004820050215.CrossRefPubMed Schumacher J, Brähler E: The prevalence of pain in the German population: results of population-based studies with the Giessen Subjective Complaints List (Giessener Beschwerdebogen GBB). Schmerz. 1999, 13: 375-384. 10.1007/s004820050215.CrossRefPubMed
34.
go back to reference Yu HY, Tang FI, Kuo BI, Yu S: Prevalence, interference, and risk factors for chronic pain among Taiwanese community older people. Pain Manag Nurs. 2006, 7: 2-11. 10.1016/j.pmn.2005.12.002.CrossRefPubMed Yu HY, Tang FI, Kuo BI, Yu S: Prevalence, interference, and risk factors for chronic pain among Taiwanese community older people. Pain Manag Nurs. 2006, 7: 2-11. 10.1016/j.pmn.2005.12.002.CrossRefPubMed
36.
go back to reference Wang HM, Beyer M, Gensichen J, Gerlach FM: Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health. 2008, 8: 246-10.1186/1471-2458-8-246.CrossRefPubMedPubMedCentral Wang HM, Beyer M, Gensichen J, Gerlach FM: Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health. 2008, 8: 246-10.1186/1471-2458-8-246.CrossRefPubMedPubMedCentral
37.
go back to reference Göbel H: Epidemiology and costs of chronic pain syndromes exemplified by specific and unspecific low back pain. Schmerz. 2001, 15: 92-98. 10.1007/s004820170031.CrossRefPubMed Göbel H: Epidemiology and costs of chronic pain syndromes exemplified by specific and unspecific low back pain. Schmerz. 2001, 15: 92-98. 10.1007/s004820170031.CrossRefPubMed
38.
go back to reference Sleed M, Eccleston C, Beecham J, Knapp M, Jordan A: The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study. Pain. 2005, 119: 183-190. 10.1016/j.pain.2005.09.028.CrossRefPubMed Sleed M, Eccleston C, Beecham J, Knapp M, Jordan A: The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study. Pain. 2005, 119: 183-190. 10.1016/j.pain.2005.09.028.CrossRefPubMed
39.
go back to reference Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R: Lost productive time and cost due to common pain conditions in the US workforce. Jama. 2003, 290: 2443-2454. 10.1001/jama.290.18.2443.CrossRefPubMed Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R: Lost productive time and cost due to common pain conditions in the US workforce. Jama. 2003, 290: 2443-2454. 10.1001/jama.290.18.2443.CrossRefPubMed
40.
go back to reference Council S: Reports from the Swedish Council on Technology Assessment in Health Care. Back pain. Int J Technol Assess Health Care. 2000, 16: 929-943. Council S: Reports from the Swedish Council on Technology Assessment in Health Care. Back pain. Int J Technol Assess Health Care. 2000, 16: 929-943.
41.
go back to reference Blyth FM, March LM, Nicholas MK, Cousins MJ: Chronic pain, work performance and litigation. Pain. 2003, 103: 41-47. 10.1016/S0304-3959(02)00380-9.CrossRefPubMed Blyth FM, March LM, Nicholas MK, Cousins MJ: Chronic pain, work performance and litigation. Pain. 2003, 103: 41-47. 10.1016/S0304-3959(02)00380-9.CrossRefPubMed
42.
go back to reference Lang E, Kastner S, Liebig K, Neundorfer B: Interventions for improvement of primary care in patients with low back pain: how effective are advice to primary care physicians on therapies and a multimodal therapy program arising out of cooperation of outpatient health care structures?. Schmerz. 2002, 16: 22-33. 10.1007/s004820100091.CrossRefPubMed Lang E, Kastner S, Liebig K, Neundorfer B: Interventions for improvement of primary care in patients with low back pain: how effective are advice to primary care physicians on therapies and a multimodal therapy program arising out of cooperation of outpatient health care structures?. Schmerz. 2002, 16: 22-33. 10.1007/s004820100091.CrossRefPubMed
43.
go back to reference Strumpf M, Willweber-Strumpf A, Zenz M: Economic aspects of pain therapy. Z Ärztl Fortbild Qualitätssich. 1998, 92: 65-69.PubMed Strumpf M, Willweber-Strumpf A, Zenz M: Economic aspects of pain therapy. Z Ärztl Fortbild Qualitätssich. 1998, 92: 65-69.PubMed
44.
go back to reference Robert-Koch-Institut Fhr: Health in Germany. Health in Germany. 2008, Robert Koch Institute; Germany Robert-Koch-Institut Fhr: Health in Germany. Health in Germany. 2008, Robert Koch Institute; Germany
45.
go back to reference Strumpf M, Zenz M, Willweber-Strumpf A: Analysis of the therapy of chronic pain. A comparison of previous therapy and specialized pain therapy. Anaesthesist. 1993, 42: 169-174.PubMed Strumpf M, Zenz M, Willweber-Strumpf A: Analysis of the therapy of chronic pain. A comparison of previous therapy and specialized pain therapy. Anaesthesist. 1993, 42: 169-174.PubMed
46.
go back to reference Bergman S, Herrstrom P, Jacobsson LT, Petersson IF: Chronic widespread pain: a three year followup of pain distribution and risk factors. J Rheumatol. 2002, 29: 818-825.PubMed Bergman S, Herrstrom P, Jacobsson LT, Petersson IF: Chronic widespread pain: a three year followup of pain distribution and risk factors. J Rheumatol. 2002, 29: 818-825.PubMed
47.
go back to reference Elliott AM, Smith BH, Hannaford PC, Smith WC, Chambers WA: The course of chronic pain in the community: results of a 4-year follow-up study. Pain. 2002, 99: 299-307. 10.1016/S0304-3959(02)00138-0.CrossRefPubMed Elliott AM, Smith BH, Hannaford PC, Smith WC, Chambers WA: The course of chronic pain in the community: results of a 4-year follow-up study. Pain. 2002, 99: 299-307. 10.1016/S0304-3959(02)00138-0.CrossRefPubMed
48.
go back to reference Watkins EA, Wollan PC, Melton LJ, Yawn BP: A population in pain: report from the Olmsted County health study. Pain Med. 2008, 9: 166-174. 10.1111/j.1526-4637.2007.00280.x.CrossRefPubMed Watkins EA, Wollan PC, Melton LJ, Yawn BP: A population in pain: report from the Olmsted County health study. Pain Med. 2008, 9: 166-174. 10.1111/j.1526-4637.2007.00280.x.CrossRefPubMed
49.
go back to reference Blyth FM, March LM, Brnabic AJ, Jorm LR, Williamson M, Cousins MJ: Chronic pain in Australia: a prevalence study. Pain. 2001, 89: 127-134. 10.1016/S0304-3959(00)00355-9.CrossRefPubMed Blyth FM, March LM, Brnabic AJ, Jorm LR, Williamson M, Cousins MJ: Chronic pain in Australia: a prevalence study. Pain. 2001, 89: 127-134. 10.1016/S0304-3959(00)00355-9.CrossRefPubMed
50.
go back to reference Mallen C, Peat G, Thomas E, Croft P: Severely disabling chronic pain in young adults: prevalence from a population-based postal survey in North Staffordshire. BMC Musculoskelet Disord. 2005, 6: 42-10.1186/1471-2474-6-42.CrossRefPubMedPubMedCentral Mallen C, Peat G, Thomas E, Croft P: Severely disabling chronic pain in young adults: prevalence from a population-based postal survey in North Staffordshire. BMC Musculoskelet Disord. 2005, 6: 42-10.1186/1471-2474-6-42.CrossRefPubMedPubMedCentral
51.
go back to reference Blyth FM, March LM, Brnabic AJ, Cousins MJ: Chronic pain and frequent use of health care. Pain. 2004, 111: 51-58. 10.1016/j.pain.2004.05.020.CrossRefPubMed Blyth FM, March LM, Brnabic AJ, Cousins MJ: Chronic pain and frequent use of health care. Pain. 2004, 111: 51-58. 10.1016/j.pain.2004.05.020.CrossRefPubMed
52.
go back to reference Buskila D, Abramov G, Biton A, Neumann L: The prevalence of pain complaints in a general population in Israel and its implications for utilization of health services. J Rheumatol. 2000, 27: 1521-1525.PubMed Buskila D, Abramov G, Biton A, Neumann L: The prevalence of pain complaints in a general population in Israel and its implications for utilization of health services. J Rheumatol. 2000, 27: 1521-1525.PubMed
53.
go back to reference Andersson HI, Ejlertsson G, Leden I, Schersten B: Impact of chronic pain on health care seeking, self care, and medication. Results from a population-based Swedish study. J Epidemiol Community Health. 1999, 53: 503-509. 10.1136/jech.53.8.503.CrossRefPubMedPubMedCentral Andersson HI, Ejlertsson G, Leden I, Schersten B: Impact of chronic pain on health care seeking, self care, and medication. Results from a population-based Swedish study. J Epidemiol Community Health. 1999, 53: 503-509. 10.1136/jech.53.8.503.CrossRefPubMedPubMedCentral
54.
go back to reference Niv D, Devor M: Position paper of the European Federation of IASP Chapters (EFIC) on the subject of pain management. Eur J Pain. 2007, 11: 487-489. 10.1016/j.ejpain.2007.03.005.CrossRefPubMed Niv D, Devor M: Position paper of the European Federation of IASP Chapters (EFIC) on the subject of pain management. Eur J Pain. 2007, 11: 487-489. 10.1016/j.ejpain.2007.03.005.CrossRefPubMed
55.
go back to reference Stannard C, Johnson M: Chronic pain management–can we do better? An interview- based survey in primary care. Curr Med Res Opin. 2003, 19: 703-706. 10.1185/030079903125002478.CrossRefPubMed Stannard C, Johnson M: Chronic pain management–can we do better? An interview- based survey in primary care. Curr Med Res Opin. 2003, 19: 703-706. 10.1185/030079903125002478.CrossRefPubMed
56.
go back to reference Smith BH, Elliott AM, Chambers WA, Smith WC, Hannaford PC, Penny K: The impact of chronic pain in the community. Fam Pract. 2001, 18: 292-299. 10.1093/fampra/18.3.292.CrossRefPubMed Smith BH, Elliott AM, Chambers WA, Smith WC, Hannaford PC, Penny K: The impact of chronic pain in the community. Fam Pract. 2001, 18: 292-299. 10.1093/fampra/18.3.292.CrossRefPubMed
Metadata
Title
Chronic pain in primary care. German figures from 1991 and 2006
Authors
Christine H Frießem
Anne Willweber-Strumpf
Michael W Zenz
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-299

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