c i a l D i s t r i b u t i o n U n a u t h o r i z e d u s e p r o h i b i t e d . A u t h o r i s e d u s e r s c a n d o w n l o a d , d i s p l a y , v i e w a n d p r i n t a s i n g l e c o p y f o r p e r s o n a l u s eJournal of Medical Economics Vol. 14, No. 3, 2011, 367-380 1369-6998 Article 0031. R1/583303 doi:10.3111/13696998.2011.583303 All rights reserved: reproduction in whole or part not permitted AbstractObjectives:The aims of this paper are to report on the prevalence, correlates and treatment of pain in the adult Spanish population. The analysis also explores the association between the experience of pain and health-related quality of life (HRQoL), employment and productivity, and healthcare resource utilization. Methods:Data are from the internet-based, 2010 National Health and Wellness Survey (NHWS) Spain. The sample was weighted by age and sex to correspond to the 2010 adult Spanish population. All respondents to the NHWS reported on socio-demographic and economic characteristics, medication adherence and major health conditions. They also reported on their HRQoL (the SF-12), their employment status and workplace productivity experience (WPAI instrument) and their healthcare resource utilization. Persons reporting experiencing pain gave details on conditions causing pain, prescription and over the counter (OTC) medication utilization, duration of utilization and satisfaction with medications. A supplementary analysis evaluated the population prevalence of pain for the five most populous Spanish autonomous communities (regions). Results:An estimated 6.10 million (17.25%) of the adult population of Spain reported experiencing pain in the last month. Of these11.69% experienced severe pain, 64.17% moderate pain and 24.14% mild pain. Daily pain was experienced by 6.95% of the population The major conditions causing pain are back pain (60.53%) followed by joint pain (40.21%). Sleep difficulties (42.24%) and anxiety (40.62%) were most commonly cited as comorbidities. Prescription medication utilization was most important in the severe and moderate pain categories, with 71.62% reporting they were satisfied with their prescription pain medications. Adherence to pain medications was high with an overall Morisky score of 0.99 (range 0-4). Pain had a major negative effect on labor force participation for those reporting moderate and severe pain with a participation rate of only 42.62% for those with severe pain. Pain was associated with substantial health-related quality of life deficits as measured by the physical and mental score components of the SF-12. In the case of SF-6D utilities, the utility score for the pain population was markedly below that for the no-pain population (0.65 vs. 0.75; p50.05).The experience of pain also negatively impacted rates of absenteeism and presenteeism, as well as being associated with greater healthcare resource utilization. Finally, for the five most populous autonomous communities of Spain estimated pain prevalence ranged from 14.80% for Madrid to 18.79% fo...

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At 6 weeks, patients with symptomatic OA of the knee showed a greater improvement in pain and functional capacity with aceclofenac than paracetamol with no difference in tolerability.

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The role of patient adherence in improving the efficacy of any treatment is widely accepted, as well as its impact in optimizing the use of healthcare resources and associated costs. Adherence is particularly affected in chronic conditions, such as rheumatoid arthritis (RA), requiring long-term therapies and a commitment of the patient to manage his/her disease. Methotrexate (MTX) is one of the mainstays of treatment for several immunemediated inflammatory joint and skin diseases, especially RA. The use of parenteral MTX, particularly when administered as a subcutaneous (SC) injection, has recently raised a great interest to overcome the limitations of oral MTX. For addressing this issue, new optimized self-injection systems have been developed to improve the ease of use of SC MTX. Increasing evidence shows how patients tend to opt for autoinjectors over prefilled syringes or conventional syringes in terms of easiness of use, preference and satisfaction, regardless of whether the treatment is a biologic or MTX. Additionally, positive views and beliefs of patients about treatment may contribute to increasing expectations of effectiveness and treatment adherence. Similarly, the implementation of prefilled pens in clinical practice might be a way to facilitate and simplify the self-injection of SC MTX delivery, optimizing adherence and treatment outcomes as a consequence. This article aimed to review the available literature data on the use of MTX autoinjectors and their impact on treatment adherence and patients' perceptions.

The experience of pain, in particular severe daily pain, has a substantial negative impact both on labor force participation in Spain as well as reported absenteeism and presenteeism. As a measure of health status, it clearly has an impact that outstrips other health status measures. Whether or not pain is considered as a disease in its own right, the experience of chronic pain, as defined here, presents policy-makers with a major challenge. Programs to relieve the burden of pain in the community clearly have the potential for substantial benefits from societal, individual, and employer perspectives.

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