Value of Treatment: Transversal Topics

Case study on Chronic Pain disorders (2021-2023)

Convinced that the inclusion of a complex issue such as chronic pain is fully in line with the concept and objectives of the VoT methodology, a new case study on this transversal topic was launched in December 2020.

The working group chaired by Professor Rolf-Detlef Treede nominated by the European Pain Federation (EFIC), includes experts nominated by the European Academy of Neurology (EAN), the European Psychiatric Association (EPA) and patient representatives from Pain Alliance Europe (PAE).

The WHO ICD-11 classification was used to select the types of chronic pain disorders to be studied.

The objectives of the study have been defined as follows:

  • To explore the patient pathway of adults of working age in three selected diseases:
    1. fibromyalgia (as an example of primary chronic pain,
    2. painful diabetic neuropathy (as an example of chronic secondary neuropathic pain)
    3. non-specific low-back pain (as an example of musculoskeletal pain considered as a common type somewhere in the continuum between chronic secondary and chronic primary pain).

The study will focus on the following gaps:

  1. Long waiting times to access primary care (GPs)
  2. Lack of referrals to secondary care between primary care – secondary care & tertiary care (for a and c).
  • To compare Interdisciplinary Multimodal Chronic Pain Management with current care = monomodal therapy (drug or physiotherapy or psychotherapy alone) in adults of working age

For the definition of ‘Interdisciplinary Multimodal Chronic Pain Management’, the working group refers to the components of interdisciplinary chronic pain management as defined by IASP and the 2017 article published in Pain Journal. In dialogue with the patients, the working group considers that Interdisciplinary Multimodal Chronic Pain Management must combine the following modalities/therapies according to a plan:

  • Medication
  • Physiotherapy
  • Psychotherapy/mental health interventions
  • Complementary medicines
  • Self-management

Self-management is used as a broader term that includes self-medication as well as patients actively involved in treatment and care decision-making. It may also include other aspects such as diet or exercise.

The economic modelling will be a disease management model with different variables: optimizing monotherapy to combination multimodal therapies, optimizing referral patterns and diagnostic times.

The study will focus on the following countries:

  • Germany
  • Sweden
  • Portugal
  • Italy
  • Slovenia

The results of the 2-year case study are due to be released by the end of 2022.

The study is supported with grants from Grünenthal and Pfizer.

For more information please contact: Françoise Van Hemelryck – EBC Senior Project Manager (frvh@braincouncil.eu)