Artículos relacionadosArtículos relacionadosArtículos relacionados
Artículos afines de siicsalud publicados en los últimos 4 meses
APREMILAST EN LA ARTRITIS PSORIÁSICA EN EL MUNDO REAL
Reumatología Clínica 20(1):23-31
Difundido en siicsalud: 20 nov 2024
EFECTOS DE LAS VITAMINAS ANTIOXIDANTES EN LA ENDOMETRIOSIS
Reproductive Biology and Endocrinology Rb&e 21(1):1-16
Difundido en siicsalud: 4 sep 2024

EL TRATAMIENTO MULTIDISCIPLINARIO DEL DOLOR MEJORA LA CALIDAD DE VIDA A MAS BAJO COSTO

(especial para SIIC © Derechos reservados)
El dolor, especialmente el crónico, implica tanto el sufrimiento de quien lo padece como una erogación dineraria, no solamente por el precio de los analgésicos empleados sino además por la pérdida de productividad debida al ausentismo laboral y otros factores conexos. De modo que para atender racionalmente el problema debe adoptarse una conducta multidisciplinaria que también atienda todos los aspectos sociales y económicos involucrados.
phillips9.jpg Autor:
Ceri j Phillips
Columnista Experto de SIIC
Artículos publicados por Ceri j Phillips
Recepción del artículo
20 de Febrero, 2006
Aprobación
17 de Mayo, 2006
Primera edición
29 de Septiembre, 2006
Segunda edición, ampliada y corregida
21 de Enero, 2008

Resumen
El dolor, cuya prevalencia estimada oscila entre 8% y 60%, constituye un verdadero problema clínico, social y económico que impacta en forma contundente sobre la economía. Así, el costo de la dorsalgia equivale a más de un quinto de los gastos totales en salud y el 1.5% del producto bruto anual de algún país, mientras que en otro puede representar hasta tres veces el gasto que demandan todos los tipos de cáncer. Sin embargo, quienes toman las decisiones concentraron su atención en un componente muy menor de los costos, por ejemplo el de los medicamentos, que en el caso de las dorsalgias es de aproximadamente el 1% del total. Además de este impacto económico, el dolor crónico es probablemente uno de los síntomas con mayores efectos perjudiciales sobre la calidad de vida; tan es así que quienes están aquejados por migraña, por ejemplo, padecen igual sufrimiento que personas con artritis, asma, diabetes o depresión. La carga que el dolor impone a los individuos y los costos enormes que como resultado debe soportar la sociedad, demuestran claramente la necesidad de un pensamiento colectivo para impulsar el proceso de toma de decisiones. Se requiere una amplia perspectiva estratégica basada en la evidencia que relacione efectividad (incluyendo tolerancia), eficiencia y equidad, a fin de establecer cuál es la mejor manera de proveer servicios y distribuir racionalmente los recursos.

Palabras clave
Dolor, economía, costo, manejo del dolor, calidad de vida


Artículo completo

(castellano)
Extensión:  +/-11.96 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
Pain represents a major clinical, social and economic problem, with estimates of its prevalence ranging from 8% to over 60%. The impact of pain on economies is enormous, with the cost of back pain alone equivalent to more than one-fifth of one country's total health expenditure and 1.5% of its annual gross domestic product, while in another it represents three times the total cost of all types of cancer. However, decision makers have tended to concentrate their attention on a very minor component of the cost burden, namely prescription costs, which, in the case of back pain, represent 1% of the total cost burden. In addition to its economic impact, chronic pain is probably one of the diseases with the greatest negative impact on quality of life. For example, the quality of life for those with migraine had been shown to be at best equal to that for people with arthritis, asthma, diabetes mellitus or depression. The burden that pain imposes on individuals and the enormous costs that society has to bear as a result clearly demonstrate the need for collective thinking in the decision-making process. A broad, strategic perspective - based on evidence relating to effectiveness (including tolerability), efficiency and equity - is required in determining issues relating to the provision of services and resource allocation.

Key words
Pain, economics, cost, pain management, quality of life


Full text
(english)
para suscriptores/ assinantes

Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Medicina del Dolor, Medicina Interna
Relacionadas: Anestesiología, Atención Primaria, Bioética, Farmacología, Medicina del Dolor, Medicina Familiar, Medicina Farmacéutica, Neurología, Oncología, Pediatría, Salud Mental



Comprar este artículo
Extensión: 11.96 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Enviar correspondencia a:
Ceri J. Phillips, Institute for Health Research, School of Health Science, Swnasea University, SA2 8PP, Singleton Park, Swansea, Reino Unido
Bibliografía del artículo
1. Bruster S, Jarman B, Bosanquet N et al. National survey of hospital patients. BMJ 1994; 309:1542-46.
2. Audit Commission. Anaesthesia under examination. Audit Commission: London, 1997.
3. McQuay HJ, Moore RA, Justins D. Treating acute pain in hospital. BMJ 1997; 314:1531-35.
4. Latham J and Davis BD. The socio-economic impact of chronic pain. Disabil Rehabil 1994; 16:39-44.
5. Rudy TE, Kerns RD, Turk DC. Chronic pain and depression: toward a cognitive behavioural model. Pain 1988; 35:129-40.
6. Merskey H, Bogduk N. Classification of chronic pain. Seattle: International Association for the Study of Pain Press, 1994:210.
7. Clark JD. Chronic pain prevalence and analgesic prescribing in a general medical population. J Pain Symptom Manage 2002; 23:131-37.
8. Zagari MJ, Mazonson PD, Longton WC. Pharmacoeconomics of chronic non-malignant pain. Pharmacoeconomics 1996; 10:356-77.
9. Verhaak PFM, Kerssens JJ, Dekker J et al. Prevalence of chronic benign pain disorder among adults:a review of the literature. Pain 1998; 77:231-39.
10. Crook J, Rideout E, Browne G. The prevalence of pain complaints in a general population. Pain 1984; 18:299-314.
11. 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; 37:215-22.
12. Van Korff M, Wagner EH, Dworkin SF et al. Chronic pain and use of ambulatory health care. Psychom Med 1991; 53:61-79.
13. Elliott AM, Smith BH, Penny KI et al. The epidemiology of chronic pain in the community. Lancet 1999; 354:1248-52.
14. Elliott AM, Smith BH, Hannaford PC et al. The course of chronic pain in the community: results of a 4-year follow-up study. Pain, 2002; 99:299-307.
15. http://www.arthritiscare.org.uk/news/detail.cfm?newsid=266®ion=uk. Accessed 23rd October 2002.
16. Reginster JY. The prevalence and burden of arthritis. Rheumatology 2002; 41 (suppl. 1):3-6.
17. National Institute for Clinical Excellence. The use of etanercept and infliximab for the treatment of rheumatoid arthritis. Technology Appraisal, No. 36.
18. Drummond MF. Cost-of-illness studies: a major headache? Pharmacoeconomics 1992; 2:1-4.
19. Koopmanschap MA, Rutten FFH, van Ineveld BM, van Roijen L. The friction cost method for measuring indirect costs of disease. Journal of Health Economics 1995; 14:171-89.
20. Borghouts JAJ, Koes BW, Vondeling H, Bouter LM. Cost-of-illness of neck pain in The Netherlands in 1996. Pain 1999; 629-36.
21. Maniadakis N and Gray A. The economic burden of back pain in the UK. Pain 2000; 84:95-103.
22. Bolten W, Kempel-Waibel A, Pforringer W. Analysis of the cost of illness in backache. Med Klin 1998; 93:388-93.
23. van Jaarsveld CHM, Jacobs JWG, Schrivers AJP et al. Direct cost of rheumatoid arthritis during the first six years: a cost-of-illness study. British Journal of Rheumatology, 1998; 37:837-47.
24. Department of Health. Prescription Cost Analysis for England 2000. http://www.doh.gov.uk/stats/pca2000.htm (Accessed October 30th 2002).
25. Walsh K, Cruddas M, Coggon D. Low back pain in eight areas of Britain. J Epidemiol Community Health 1993; 46:227-30.
26. Belsey J. Primary care workload in the management of chronic pain: A retrospective cohort study using a GP database to identify resource implications for UK primary care. Journal of Medical Economics 2002; 5:39-52.
27. Phillips CJ. The real cost of pain management. Anaesthesia 2001; 56:1031-3.
28. Merkesdal S, Mittendorf JRT, Zeidler H, Mau W. Indirect medical costs in the first 3 years of rheumatoid arthritis:comparison of current methodological approaches. Expert Rev. Pharmacoeconomics Outcomes Res, 2002; 2:313-8.
29. Frank AO, Chamberlain MA. Keeping our patients at work: implications for the management of those with rheumatoid arthritis and musculoskeletal conditions. Rheumatology, 2001; 40:1201-5.
30. Autret-Leca E, Bertin P, Boulu P et al. La doleur aiguë de l'adulte en médecine générale. Enquête épidéiologique transversale nationale. Rev Pract, 2002 ; 16:648-52.
31. Sokka T, Kautiainen H, Mottonen T, et al. Work disability in rheumatoid arthritis 10 years after the diagnosis. J Rheumatol 1999; 26:1681-5.
32. Jantti J, Aho K, Kaarela K, et al. Work disability in an inception cohort of patients with seropositive rheumatoid arthritis: a 20-year study. Rheumatology (Oxford) 1999; 38:1138-41.
33. Eberhardt K, Larsson BM, Nived K. Early rheumatoid arthritis - some social, economical, and psychological aspects. Scand J Rheumatol 1993; 22:119-23.
34. Albers JM, Kuper HH, van Riel PL, et al. Socio-economic consequences of rheumatoid arthritis in the first years of the disease. Rheumatology (Oxford) 1999; 38(5):423-30.
35. Kaarela K, Lehtinen K, Luukkainen R. Work capacity of patients with inflammatory joint diseases. An eight-year follow-up study. Scand J Rheumatol 1987; 16:403-6.
36. Smith I. Cost considerations in the use of anaesthetic drugs. Pharmacoeconomics 2001; 19:469-81.
37. Pugner KM, Scott DI, Holmes JW, et al. The costs of rheumatoid arthritis: an international long-term view. Semin Arthritis Rheum 2000; 29 (5):305-20.
38. Yelin E, Katz P, Lubeck D, et al. Impact of etanercept (ENBREL) on health care use and employment in early RA. Arthritis Rheum 2001; 44 (suppl 9):152.
39. Murray JL, Lopez AD (eds). The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge MA:Harvard University Press, 1996.
40. McQuay HJ and Moore RA. An evidence based resource for pain relief. Oxford University Press: Oxford, 1998.
41. Gureje O, Von Korff M, Simon G, et al. Persistent pain and well-being: a World Health Organization study in primary care. JAMA 1998; 280:147-51.
42. Flor H, Turk DC, Scholz OB. Impact of chronic pain on the spouse: marital, emotional and physical consequences. J Psychosom Res 1987; 31:63-71.
43. Turk DC, Flor H, Rudy TE. Pain and families. I. Etiology, maintenance and psychological impact. Pain 1987; 30:3-27.
44. Schwartz L, Slater MA, Birchler GR. The role of pain behaviors in the modulation of marital conflict in chronic pain couples. Pain 1996; 65:227-33.
45. Schwartz L, Slater MA, Birchler GR, et al. Depression in spouses of chronic pain patients: the role of patient pain and anger, and marital satisfaction. Pain 1991; 44:61-7.
46. Kemler MA and Furnée CA. The impact of chronic pain on life in the household. J Pain Symptom Manage 2002; 23:433-41.
47. Sprangers MAG, de Regt EB, Andries F, et al. Which chronic conditions are associated with a better or poorer quality of life? J Clin Epidemiol 2000; 53:895-97.
48. Becker N, Thomsens AB, Olsen AK, et al. Pain epidemiology and health related quality of life in chronic non-malignant pain patients referred to a Danish multidisciplinary pain center. Pain 1997; 73:393-400.
49. Kosinski M, Kujawski SC, Martin R, et al. Health-related quality of life in early rheumatoid arthritis: impact of disease and treatment response. Am J Manag Care 2002; 8(3):231-40.
50. Williams ACdeC. Outcome assessment in chronic non-cancer pain treatment. Acta Anaesthesiol Scan 2001; 45:1076-9.
51. Thomsen AB, Sørensen J, Sjøgren P, et al. Economic evaluation of multidisciplinary pain management in chronic pain patients: a qualitative systematic review. J Pain Symptom Manage 2001; 22:688-698.
52. Campbell FA, Tramer MR, Carroll, et al. Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review. BMJ 2001; 323:1-6.
53. Buchbinder R, Jolley D and Wyatt M. Population based intervention to change back pain beliefs and disability: three part evaluation. BMJ 2001; 322:1516-20.
54. Guzmán J, Esmail R, Karjalainen K, et al. Multidisciplinary rehabilitation for chronic low back pain: systematic review. BMJ 2001; 322:1511-6.
55. Moore RA. Pain and systematic reviews. Acta Anaesthesiol Scand 2001; 45:1136-1139.
56. Bandolier 2002. http://www.jr2.ox.ac.uk/bandolier/painresearch (accessed April 1st 2002).
57. Brooks P. Use and benefits of non-steroidal anti-inflammatory drugs. Am J Med 1998; 104:9S-13S.
58. Blower AL, Brooks A, Fenn GC, et al. Emergency admissions for upper gastrointestinal disease and their relation to NSAID use. Aliment Pharmacol Ther 1997; 11:283-91.
59. Tramer MR, Moore RA, Reynolds DJ, et al. Quantitative estimation of rare adverse events which follow a biological progression: a new model applied to chronic NSAID use. Pain 2000; 85:169-82.
60. Phillips CJ and Thompson G. What is cost effectiveness? Hayward Medical Communications: London, 1997.
61. Moore RA and Phillips CJ. Cost of NSAID adverse effects to the UK National Health Service. Journal of Medical Economics 1999; 2:45-55.
62. Jonsson B, Haglund U. Economic burden of NSAID-induced gastropathy in Sweden. Scand J Gastroenterol 2001; 36:775-79.
63. Herings RM, Klungel OH. An epidemiological approach to assess the economic burden of NSAID-induced gastrointestinal events in The Netherlands. Pharmacoeconomics 2001; 19:655-65.
64. Rahme E, Joseph L, Kong SX, et al. Gastrointestinal health care resource use and costs asscoatied with nonsteroidal anti-inflammatory drugs versus acetaminophen: retrospective cohort study of an elderly population. Arthritis and Rheumatism, 2000; 43:917-24.
65. Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients: an under-recognized public health problem. Arch Intern Med 2000; 160:777-84.
66. Phillips CJ. And all because the doctor prescribed an NSAID:expenditure on PPIs and joined-up thinking in prescribing. British Journal of Health Care Management 2002; 8:272-75.
67. Loesner JD. Economic implications of pain management. Acta Anaesthesiol Scand 1999; 43:957-59.
68. Rawal N, Allvin R, EuroPain Acute Pain Working Party. Acute pain services in Europe: a 17-nation survey of 105 hospitals. Eur J Anaesthesiol 1998; 15:354-63.
69. McQuay HJ, Moore RA, Eccleston C et al. Systematic review of outpatient services for chronic patient control. Health Technol Assess 1997; 1(6).
70. Hopton JL and Dlugolecka M. Patients' perceptions of need for primary health care services: useful for priority setting? BMJ 1995; 310:1237-40.
71. Loesner JD, Melzack R. Pain:an overview. Lancet 1999; 353:1607-09.

 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
Artículos relacionadosMás relacionadosAtículos relacionados
EFICACIA Y SEGURIDAD DE LA DULOXETINA EN EL DOLOR MUSCULOESQUELÉTICO CRÓNICO
BMC Musculoskeletal Disorders 24(1):1-12
Difundido en siicsalud: 29 jul 2024
DAPAGLIFLOZINA Y CALIDAD DE VIDA EN LA INSUFICIENCIA CARDÍACA AGUDA
Journal of the Pakistan Medical Association 74(4):621-625
Difundido en siicsalud: 4 sep 2024
ANALGESIA EN EL POSOPERATORIO DE CIRUGÍAS ORTOPÉDICAS
Cureus 15(11):1-12
Difundido en siicsalud: 19 jul 2024
ua31618
Inicio/Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008