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SIP Thematic Network - Pain as a Health Quality Indicator

SIP Thematic Network

There are a number of EU initiatives that seek to address data collection on pain, through the establishment of indicators. Whilst some exist in theory, their implementation is not consistent.

The BRIDGE-Health project provides a definition for the 37th indicator on ‘General musculoskeletal pain’. However, this indicator is still under development and no data is available in international databases[1]. Certain initiatives have built on the BRIDGE-Health project to seek further implementation, including the EU Joint Action on Health Information (InfAct) and the European Health Interview Survey (EHIS) [2]. The latter collects data in waves, the next of which will be in 2019. The survey will analyse the impact of pain through the lens of socio-economic status.

The European Commission and the OECD are also driving a two-year initiative entitled ‘the State of Health in the EU’. In its Health at a Glance: Europe report, published in November 2016, it acknowledges low employment rates affect individuals with musculoskeletal diseases[3]. In 2017, a Companion Report was published which discussed pain in relation to patient-reported outcomes. The report goes on to propose Commission co-funding of the OECD’s new Patient Reported Indicators Survey (PaRIS).The survey will focus on patient-reported outcomes, as well as analyse whether treatment reduces pain and allows the individual to experience better quality of life[4].

More recently, the 11th revision of the International Classification of Diseases (ICD-11) was revised in June 2018. This updates the definition of chronic pain, alongside other types of pain. The General Assembly is expected to implement the update in 2019. However, implementation by Member States could take longer.

Despite the above, there remains a data gap in how we measure and monitor the societal impact of pain across the EU.

SIP Recommendation for Policy Action

Develop instruments to assess the societal impact of pain (pain as a quality indicator)

SIP calls on the European Commission and Member States to explore opportunities to build on existing instruments which are available to define, establish and/or use pain as an indicator in the assessment of healthcare systems’ quality. By undertaking these actions, policymakers can contribute to the work being done to assess the societal impact of pain and fill the current data gap.

Further information about Pain as a Health Quality Indicator can be found here:

- SIP 2019: Joint Statement implementation - Pain as a quality indicator

- ICD-11 Flyer and Background Information

- ICF Flyer and Background Information

- SIP 2017, Working Group 1: Pain as a Quality indicator for health care systems

- SIP 2016, Working Group 1: Pain as a Quality indicator for health care

- SIP 2016, Michael Schäfer: Pain as a Health Quality indicator in Germany

- Prof. Rolf-Detlef Treede: Can we use pain as a quality indicator for health care?

- SIP Factsheet: Pain as a quality indicator for health care


Please see the SIP Framing Paper and Call to Action for further information.



[3] (pg. 22)


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