1. 2018;21;E533-E543Patients’ Perceptions of Chronic Pain During the Economic Crisis: Lessons Learned from Greece
   Prospective Study
   Chrysanthi Batistaki, MD, PhD, Philippe Mavrocordatos, MD, PhD, Maria-Eleni Smyrnioti, MSc, George Lyrakos, PhD, Maria-Chrysanthi Kitsou, MD, Georgia Stamatiou, MD, PhD, and Georgia Kostopanagiotou, MD, PhD.

BACKGROUND: Chronic pain is well known to be influenced by various social factors; however, the impact of financial issues on pain has not been extensively studied.

OBJECTIVE: The aim of this study was to investigate the impact of the economic crisis on pain and quality of life in Greek patients suffering from chronic pain.

STUDY DESIGN: The study employed a prospective, open-label design.

SETTING: The study setting was the Pain Unit of Attikon University Hospital in Athens, Greece.

METHODS: The study surveyed 200 randomly selected outpatients with chronic pain during two different time periods (2012 and 2016). Patients completed a structured questionnaire to assess the impact of the economic crisis on multiple aspects of pain and pain management, health care, and quality of life. Personality characteristics and stress were also evaluated using the DASS-42 and the LOT-R questionnaires.

RESULTS: Most patients in both periods believed that the economic crisis led to a worsening of their symptoms (75%) and quality of life (97%). Most patients (97.5%) also believed that the intensity of their pain would have been improved if their financial status had been better. Their main concerns about the future were “the possibility of not having access to health care facilities and medication” (94.5%), “stress” (43%), and “fear of financial strain” (30.5%). Higher levels of anxiety, stress, and pessimism were associated with higher levels of pain and lower quality of life.

LIMITATIONS: The study is based on a small sample size.

CONCLUSIONS: This study identified impacts of the financial crisis on chronic pain and quality of life, pointing to the need for measures to solve this problem.

KEY WORDS: Pain, global financial crisis, quality of life, quality of health care, psychosocial factors