OP0347 PARE THE INFLUENCE OF PAIN ON SLEEP PROBLEMS, MENTAL HEALTH AND USE OF STRONG PAINKILLERS AMONG PATIENTS WITH ARTHRITIS
Authors: Lene Mandrup Thomsen
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Chronic pain is a part of daily life for many people with RMD and leads to reduced quality of life, high risk of losing work ability, impaired functions and a poor social life. The chronic pain also means that many patients need painkillers. In Denmark there is a very high consumption of strong painkillers (opioids) compared to the other countries in Scandinavia. Therefore, the authorities have a great focus on reducing this and are urging the doctors to reduce the prescription of strong painkillers to patients with chronic pain, including patients with RMDs. In the Danish Rheumatism Association, we have many inquiries to our professional helpline from patients regarding pain. Especially about the use of painkillers, sleeping problems caused by pain, and the negative influence that pain has on one's mood. The patients experience side effects and discomfort associated with the painkillers. Some must phase out their consumption of strong painkillers, because of the authorities' focus on this - and have problems with this. In order to get a more detailed knowledge about the influence of pain among patients with RMD, the Danish Rheumatism Association made this study. <h3>Objectives</h3> To investigate the influence of pain on sleeping problems, mental health and the use of strong painkillers among members of a user-panel. <h3>Methods</h3> The study was carried out in November 2018 as an online questionnaire survey sent to 1328 members of a user-panel in The Danish Rheumatism Association. 69% answered the questionnaire. The user-panel consists of people with at least one RMD. It is not representative of patients with RMD in Denmark. <h3>Results</h3> The most important results are: <h3>Sleep</h3> 67% rarely or never feel fully rested when they wake up in the morning, and 36% takes painkillers to improve their sleep. 69% have experienced that the quality of their sleep has affected their pain negatively. Mental health: During the past four weeks, 58% have felt that everything is unmanageable for them due to pain, 11% indicated having had thoughts of taking their own life due to pain, and 45% have not wanted to be together with other people because of their pain. Use of strong painkillers: 83% have pain on a daily basis or several times a week. Among these, 46% have received strong painkillers over the last year, and 78% have not been offered alternatives to strong painkillers. More results from the survey will be presented on EULAR. <h3>Conclusion</h3> The study indicates that pain and poor quality of sleep, has surprisingly large influence on patient's daily life. More than one third takes painkillers to improve their sleep. Pain seems to have a severe negative influence on their sleep and reversed - poor sleep worsens their pain. Surprisingly many are still using strong painkillers, despite the authorities focus on reducing prescription of strong painkillers, and the patients' state, that they are not been given an alternative to strong painkillers. Finally, the study shows that pain has a surprisingly negative influence on mental health and the patients' hope for the future. In general, it has been a surprise for the Danish Rheumatism Association, that pain has such a huge impact on the participants' daily life, especially on their mental health. Therefore, the organization has been using the result of this study in our political work for better treatment and support to patients with chronic pain in our healthcare system, and in our political campaigning about the importance of a focus on pain among patients with RMDs. It is to be explained on EULAR, how we more concrete have applied the results of the study in our political work. <h3>Disclosure of Interests</h3> None declared