Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
Health-resource use and costs associated with fibromyalgia in France, Germany, and the United States
Background Fibromyalgia ( FM ) is a chronic disorder characterized by widespread , persistent pain . Prospect i ve and retrospective studies have demonstrated substantial health-care costs associated with FM in a number of countries . This study evaluated and compared health-re source use ( HRU ) and associated costs related to FM in routine clinical practice across the US , France , and Germany . Methods Two separate , cross-sectional , observational studies of subjects with FM were conducted : one in the US and one in France and Germany .  HRU related to prescription medication , physician office visits , diagnostic tests , and hospitalizations was abstract ed from chart review ; patient out-of-pocket costs and lost productivity were collected via subject self-report . Costs were assigned to HRU based on st and ard algorithms . Direct and indirect costs were evaluated and compared by simple linear regression . Results A total of 442 subjects ( 203 US , 70 France , 169 Germany ) with FM were analyzed . The mean ( st and ard deviation ) age in the US , France , and Germany was 47.9 ( 10.9 ) , 51.2 ( 9.5 ) , and 49.2 ( 9.8 ) , respectively ( P = 0.085 ) . Most subjects were female ( 95 % US , 83 % France , 80 % Germany ) ( P < 0.001 ) . Adjusted annual direct costs per subject for FM were significantly higher in the US ( $ 7087 ) than in France ( $ 481 , P < 0.001 ) or Germany ( $ 2417 , P < 0.001 ) . Adjusted mean annual indirect costs per subject for FM were lower in the US ( $ 6431 ) than in France ( $ 8718 ) or Germany ( $ 10,001 ) , but represented a significant proportion of total costs in all countries . Conclusion The significant HRU and costs associated with FM in the US , France , and Germany documented in this study highlight the substantial global economic burden of FM . Indirect costs represented a significant proportion of the total costs , particularly in Europe . Comparisons between the three countries show differences in HRU , with significantly higher direct costs in the US compared with France and Germany
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .