Abstract
Objectives
Chronic pain affects between 10–20 % of the population of Japan and several specific types of chronic pain have been found to be associated with worse health outcomes. The aim of the current study was to investigate the economic burden of chronic pain as well as the health status among Japanese patients.
Methods
Data from the Japan National Health and Wellness Survey (NHWS), a cross-sectional health survey of adults, were used (N = 30,000). Respondents with chronic pain (N = 785) were compared with respondents without chronic pain (N = 29,215) with respect to health status (using the SF-12v2), work productivity and activity impairment (WPAI questionnaire), and healthcare resource use using regression modeling, controlling for demographic and health history covariates. Indirect costs were calculated using wage rates and the human capital method.
Results
Back pain (72.10 %) and shoulder pain/stiffness (54.90 %) were the most prevalent pain types. Adjusting for demographic and health history differences, respondents with chronic pain reported lower health status [mental component summary (MCS): 44.26 vs. 51.14; physical component summary (PCS): 44.23 vs. 47.48; both p < 0.05], greater absenteeism (4.74 vs. 2.74 %), presenteeism (30.19 vs. 15.19 %), overall work impairment (31.70 vs. 16.82 %), indirect costs (¥1488,385 vs. ¥804,634), activity impairment (33.45 vs. 17.25 %), physician visits (9.31 vs. 4.08), emergency room (ER) visits (0.19 vs. 0.08), and hospitalizations (0.71 vs. 0.34) (all p < 0.05). Nearly 60 % of respondents with chronic pain were untreated. The mean level of pain severity in the last week was 5.26 (using a 0–11 scale); being female, being elderly, having low income, and having multiple pain types were significantly associated with greater pain severity (all p < 0.05). Regular exercise was associated with lower pain severity (p < 0.05).
Conclusions
The results suggest that chronic pain has a significant association in an individual’s health status, work productivity, daily activity impairment, healthcare resource use, and economic burden in Japan. Along with low treatment rates, a multidisciplinary approach may lead to an improved quality of life and reduce the economic burden among patients with chronic pain in Japan.
Similar content being viewed by others
References
International Association for the Study of Pain. Classification for chronic pain. Pain. 1986; Suppl 3:S1–S225.
Ospina M, Harstall C. Prevalence of chronic pain: an overview. Alberta Heritage Foundation for Medical Research, Health Technology Assessment. Edmonton, AB: 2002; Report No. 28.
Ogawa S, Iseki M, Kikuchi S. A large-scale survey on chronic pain and neuropathic pain in Japan [Japanese]. Clin Orthop Surg. 2012;47(6):565–74.
Institute of Medicine Report, Institute of Medicine (US), Committee on Advancing Pain Research, Care, and Education. Relieving pain in America A blueprint for transforming prevention, care, education, and research. Washington: National Academies Press; 2011.
Langley PC. The societal burden of pain in Germany: health-related quality-of-life, health status and direct medical costs. J Med Econ. 2012;15(6):1201–15.
McDonald M, DiBonaventura MD, Ullman S. Musculoskeletal pain in the workforce: the effects of back, arthritis, and fibromyalgia pain on quality of life and work productivity. J Occup Environ Med. 2011;53(7):765–70.
Nakamura M, Nishiwaki Y, Ushida T, Toyama Y. Prevalence and characteristics of chronic musculoskeletal pain in Japan. J Orthop Sci. 2011;16(16):424–32.
Nishiwaki Y, Michikawa T, Yamada M, Eto N, Takebayashi T, Kurabuchi Study Group. Knee pain and future self-reliance in older adults: evidence from a community-based 3-year cohort study in Japan. J Epidemiol. 2011;21(3):184–90.
DiBonaventura MD, Fukuda T, Stankus AP. The effect of neuropathic pain on health status, work productivity loss, and healthcare resource use in Japan. ISPOR Asia-Pacific Conference, Taipei, Taiwan. Sept 2012.
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(4):287–333.
Lightspeed Research. Lightspeed Research Panel Book. Warren, NJ: Lightspeed LLC; 2011.
Liu GG, DiBonaventura MD, Yuan Y, Wagner JS, L’Italien GJ, Langley P, Kamae I. The burden of illness for patients with viral hepatitis C: evidence from a national survey in Japan. Value Health. 2012;15:S65–71.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.
Ware JE, Kosinski M, Turner-Bowker D, Gandek B. How to score version 2 of the SF-12 health survey. Lincoln: QualityMetric Incorporated; 2002.
Brazier JE, Roberts J. The estimation of a preference-based measure of health from the SF-12. Med Care. 2004;42(9):851–9.
Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics. 1993;4(5):353–65.
Ministry of health, labour and welfare. Summary report of basic survey on wage structure (Nationwide) 2011. http://www.mhlw.go.jp/english/database/db-l/dl/23gaikyo_zenkoku_Eng.pdf. Accessed April 11 2014.
Crichton B, Green M. GP and patient perspectives on treatment with non-steroidal anti-inflammatory drugs for the treatment of pain in osteoarthritis. Curr Med Res Opin. 2002;18(2):92–6.
Johannes CB, Le TK, Zhou X, Johnston JA, Dworkin RH. The prevalence of chronic pain in United States adults: results of an Internet-based survey. J Pain. 2010;11(11):1230–9.
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(2):147–51.
Acknowledgments
This study was funded by Pfizer Japan, Inc. KF and NE are currently full-time employees of Pfizer Japan, Inc. The NHWS is a survey conducted by, with the associated data owned by, Kantar Health. Pfizer Japan, Inc. purchased access to the NHWS 2011 database and commissioned Kantar Health to analyze the data for this study and assist in the preparation of this manuscript. MD is a full-time employee of Kantar Health. TTak, TU, TK, and TTag each received a consultancy fee from Pfizer Japan, Inc. for their participation in the study advisory board.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Takura, T., Ushida, T., Kanchiku, T. et al. The societal burden of chronic pain in Japan: an internet survey. J Orthop Sci 20, 750–760 (2015). https://doi.org/10.1007/s00776-015-0730-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00776-015-0730-8