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Epidemiologie von nicht tumorbedingten chronischen Schmerzen in Deutschland

Epidemiology of chronic non-malignant pain in Germany

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Zusammenfassung

Hintergrund

Obwohl verbreitet, liegen Angaben zu epidemiologischen Aspekten chronischer Schmerzen nur eingeschränkt vor. Ziel der Arbeit ist es, Informationen zu nicht tumorbedingten chronischen Schmerzen in Deutschland darzustellen.

Methoden

Sieben Datenbanken (1995–2009) und weitere Quellen wurden durchsucht, um relevante Arbeiten zu chronischen Schmerzen (>3 Monate) zu finden. Die Auswahl erfolgte nach Aktualität, Größe, Repräsentativität und Qualität.

Ergebnisse

Die Prävalenz chronischer Schmerz in Deutschland beträgt rund 17% und variiert je nach Ursache. Besonders häufig sind Nacken-, Schulter- und Rückenschmerzen.

Chronische Schmerzen haben einen direkten Einfluss auf Lebensqualität (LQ), Krankheitstage und -kosten.

Viele medikamentöse und nichtmedikamentöse Therapien werden eingesetzt. Die Behandlung ist oft nicht adäquat, 13–51% der Patienten erhalten eine ungenügende Schmerztherapie.

Schlussfolgerung

Chronische Schmerzen sind ein häufiges Problem. Sie nehmen Einfluss auf die LQ der Patienten und verursachen nicht unerhebliche Behandlungskosten. Die Therapie erfolgt oft nicht adäquat. Mehr Forschung ist erforderlich, um vorhandene Wissenslücken zu schließen. Der Transfer von Forschungsergebnissen in die Praxis sollte verstärkt werden.

Abstract

Background

Although chronic pain is a common health problem, epidemiological data are rare. The aim of this study is to present information on chronic, non-malignant pain in Germany.

Methods

In order to identify relevant studies on chronic pain (>3 months) a total of 7 databases were searched in the timeframe from 1995 to 2009. Representative, recent, comprehensive and valid studies were selected.

Results

The prevalence of chronic pain in Germany is estimated to be 17% and varies according to the underlying cause of the disease. Neck, shoulder and back pain are the most common forms. Chronic pain has a direct impact on quality of life (QoL), days off work and costs. A variety of drugs and non-drug treatments are used. However, treatment is often inadequate with 13–51% of the patients receiving insufficient pain therapy.

Conclusions

Chronic pain is a common problem which influences the QoL of patients resulting in high costs for the health system. Treatment is often inadequate. More research is needed to close knowledge gaps. The transfer of research results into clinical practice should be improved.

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Notes

  1. Angaben aus dem Statistischen Jahrbuch für 2007: >18 Jahre: n=68.247.754; >14 Jahre: n=71.757.751; >15 Jahre: n=70.936.141; 18–80 Jahre: n=64.301.298; > 40: n=45.717.600; arbeitende Bevölkerung im Alter zwischen 40–54: n=15.794.000; 51% weiblich.

  2. Nicht ausschließlich zu chronischen Schmerzen. Einzige Studien mit bevölkerungsbezogenen Angaben zu Schulter- und Nackenschmerzen. Wird durch Komarahadi et al. [15] verwendet.

  3. Keine Studie repräsentativ für die Gesamtbevölkerung, jedoch Angaben zum Anteil von Patienten mit neuropathischen chronischen Schmerzen und Hochrechnung auf Daten des Bundesgesundheitssurveys [14].

  4. Als Berechnungsgrundlage für die Hochrechnung zur Schätzung der Prävalenz der diabetischen Neuropathie in der Gesamtbevölkerung verwendet.

  5. Keine Angaben zur Gesamtbevölkerung. Enthält Angaben zu verschiedenen Schmerzdiagnosen.

Abbreviations

ANOVA:

„analysis of variance”

BIP:

Bruttoinlandsprodukt

BMI:

Body-Mass-Index

CDSR:

Cochrane Database of Systematic Reviews

CENTRAL:

Cochrane Central Register of Controlled Trials

CRD:

Centre for Reviews and Dissemination

CS:

Chronifizierungsstadium

DARE:

Database of Abstracts of Reviews of Effects

DT:

Duncan-Test

EMBASE:

Excerpta Medica Database

EU NHWS:

EU National Health and Wellness Survey

GBPRN:

German Back Pain Research Network

GEK:

Gmünder Ersatzkasse

GIN:

Guidelines International Network

HTA:

Health Technology Assessment

ICD:

International Statistical Classification of Diseases and Related Health Problems

IMS:

Intercontinental Marketing Services

KI:

Konfidenzintervall

LFESSQ:

London Fibromyalgia Epidemiology Study Screening Questionnaire

m:

männlich

MEDLINE:

Medical Literature Analysis and Retrieval System Online

min:

Minute

MNSI:

Michigan Neuropathic Screening Instrument

MPSS:

Mainz Pain Staging System

MW:

Mittelwert

n:

Anzahl

NRS:

numerische Ratingskala

Ovid:

Ovid Technologies, Inc.

p:

„probability“ (Wahrscheinlichkeit)

RKI:

Robert-Koch-Institut

S.:

Schmerz(en)

SD:

„standard deviation“ (Standardabweichung)

SE:

„standard error“ (Standardfehler)

SF:

Short Form Health Survey

TENS:

transkutane elektrische Nervenstimulation

VA:

ANOVA (s.o.)

VAS:

visuelle Analogskala

w:

weiblich

WHO:

World Health Organisation (Weltgesundheitsorganisation)

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Die vorliegende Arbeit wurde durch die Grünenthal GmbH in Auftrag gegeben und finanziert. Grünenthal wurde die Möglichkeit gegeben, den Entwurf dieser Arbeit zu kommentieren, wobei die Autoren volle Freiheiten bezüglich Inhalt und Ausgestaltung der Publikation hatten.

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Authors and Affiliations

  1. Kleijnen Systematic Reviews Ltd, Unit 6, Escrick Business Park, Riccall Road, Escrick, YO19 6FD, York, UK

    R. Wolff & J. Kleijnen MD, PhD

  2. Researcher in Systematic Reviews, Berlin, Deutschland

    C. Clar

  3. Researcher in Systematic Reviews, Hannover, Deutschland

    C. Lerch

  4. Care and Public Health Research Institute (CAPHRI), Universität Maastricht, Maastricht, Niederlande

    J. Kleijnen MD, PhD

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  1. R. Wolff
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  2. C. Clar
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Correspondence to J. Kleijnen MD, PhD.

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Wolff, R., Clar, C., Lerch, C. et al. Epidemiologie von nicht tumorbedingten chronischen Schmerzen in Deutschland. Schmerz 25, 26–44 (2011). https://doi.org/10.1007/s00482-010-1011-2

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