ArticleBMJ open2018
The Pain Divide: a cross-sectional analysis of chronic pain prevalence, pain intensity and opioid utilisation in England.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis.BMC geriatrics · 2023Pooled it
- An application of matching algorithms to generalize small-area estimates of chronic pain prevalence to neighbourhoods across England.Journal of public health (Oxford, England) · 2025Article
- Geographical disparities in fibromyalgia severity: An Italian study.European journal of pain (London, England) · 2025Article
- Pain severity and opioid use in patients with spine-related diagnoses.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Experience of compassion-based practice in mindfulness for health for individuals with persistent pain.British journal of pain · 2024Article
- Changes in opioid prescribing during the COVID-19 pandemic in England: an interrupted time-series analysis in the OpenSAFELY-TTP cohort.The Lancet. Public health · 2024Article
- Where does it hurt? Small area estimates and inequality in the prevalence of chronic pain.European journal of pain (London, England) · 2023Article
- Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting: Qualitative Study.JMIR human factors · 2023Article
- Article
- Opioid prescribing and social deprivation: A retrospective analysis of prescribing for CNCP in Liverpool CCG.PloS one · 2023Observational
- Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015.British journal of pain · 2022Article
- The Gender Pain Gap: gender inequalities in pain across 19 European countries.Scandinavian journal of public health · 2022Article
- The relationship between patients' income and education and their access to pharmacological chronic pain management: A scoping review.Canadian journal of pain = Revue canadienne de la douleur · 2022Article
- Does Gender Moderate the Relationship Between Chronic Pain and Substance Use Disorder? Insights From a National Canadian Population Survey.Frontiers in psychiatry · 2022Article
- A Quality-of-Life Evaluation Study Assessing Health-Related Quality of Life in Patients Receiving Medicinal Cannabis (the QUEST Initiative): Protocol for a Longitudinal Observational Study.JMIR research protocols · 2021Article
- Association between clusters of back and joint pain with opioid use in middle-aged community-based women: a prospective cohort study.BMC musculoskeletal disorders · 2021Article
- Article
- Living with opioids: A qualitative study with patients with chronic low back pain.Health expectations : an international journal of public participation in health care and health policy · 2020Article
- An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England.BMC public health · 2020Article
- Regional Differences in Opioid Prescribing in Germany - Results of an Analysis of Health Insurance Data of 57 Million Adult People.Journal of pain research · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesOur central research question was, in England, are geographical inequalities in opioid use driven by health need (pain)? To answer this question, our study examined: (1) if there are regional inequalities in rates of chronic pain prevalence, pain intensity and opioid utilisation in England; (2) if opioid use and chronic pain are associated after adjusting for individual-level and area-level confounders.
designCross-sectional study design using data from the Health Survey for England 2011.
settingEngland. PRIMARY AND SECONDARY OUTCOME MEASURES: Chronic pain prevalence, pain intensity and opioid utilisation.
participantsParticipant data relating to chronic pain prevalence, pain intensity and opioid usage data were obtained at local authority level from the Health Survey for England 2011; in total, 5711 respondents were included in our analysis.
methodsRegional and local authority data were mapped, and a generalised linear model was then used to explore the relationships between the data. The model was adjusted to account for area-level and individual-level variables.
resultsThere were geographical variations in chronic pain prevalence, pain intensity and opioid utilisation across the English regions-with evidence of a 'pain divide' between the North and the South, whereby people in the North of England more likely to have 'severely limiting' or 'moderately limiting' chronic pain. The intensity of chronic pain was significantly and positively associated with the use of opioid analgesics.
conclusionsThere are geographical differences in chronic pain prevalence, pain intensity and opioid utilisation across England-with evidence of a 'pain divide'. Given the public health concerns associated with the long-term use of opioid analgesics-and their questionable activity in the management of chronic pain-more guidance is needed to support prescribers in the management of chronic pain, so the initiation of opioids can be avoided.
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