RT Journal Article
SR Electronic
T1 The Pain Divide: a cross-sectional analysis of chronic pain prevalence, pain intensity and opioid utilisation in England
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e023391
DO 10.1136/bmjopen-2018-023391
VO 8
IS 7
A1 Adam Todd
A1 Nasima Akhter
A1 Joanne-Marie Cairns
A1 Adetayo Kasim
A1 Nick Walton
A1 Amanda Ellison
A1 Paul Chazot
A1 Sam Eldabe
A1 Clare Bambra
YR 2018
UL http://bmjopen.bmj.com/content/8/7/e023391.abstract
AB Objectives Our central research question was, in England, are geographical inequalities in opioid use driven by health need (pain)? To answer this question, our study examined: (1) if there are regional inequalities in rates of chronic pain prevalence, pain intensity and opioid utilisation in England; (2) if opioid use and chronic pain are associated after adjusting for individual-level and area-level confounders.Design Cross-sectional study design using data from the Health Survey for England 2011.Setting England.Primary and secondary outcome measures Chronic pain prevalence, pain intensity and opioid utilisation.Participants Participant data relating to chronic pain prevalence, pain intensity and opioid usage data were obtained at local authority level from the Health Survey for England 2011; in total, 5711 respondents were included in our analysis.Methods Regional and local authority data were mapped, and a generalised linear model was then used to explore the relationships between the data. The model was adjusted to account for area-level and individual-level variables.Results There were geographical variations in chronic pain prevalence, pain intensity and opioid utilisation across the English regions—with evidence of a ‘pain divide’ between the North and the South, whereby people in the North of England more likely to have ‘severely limiting’ or ‘moderately limiting’ chronic pain. The intensity of chronic pain was significantly and positively associated with the use of opioid analgesics.Conclusions There are geographical differences in chronic pain prevalence, pain intensity and opioid utilisation across England—with evidence of a ‘pain divide’. Given the public health concerns associated with the long-term use of opioid analgesics—and their questionable activity in the management of chronic pain—more guidance is needed to support prescribers in the management of chronic pain, so the initiation of opioids can be avoided.