Epidemiology and treatment of pain in Italy: Part I

Abstract

Chronic pain can be debilitating and often becomes the defining factor in patients' lives. Many trials have been developed to evaluate the extent and quality of pain in specific populations. The most important informations result from the study “Pain in Europe”, published in 2006, that showed a prevalence of pain by 19%; low back pain was the most frequent disease; one third of the interviewed people complained the worst imaginable pain; on average, people lived with chronic pain for 7.7 years. In regard to the treatment of pain in Italy, the same survey shows inadequate treatment in 47% of cases; 42% of patients reported the assumption of drugs; in 68% of cases Italian doctors prescribed NSAIDs; no patient was in treatment with strong opioids. The link between the reduced use of opioids in Italy and the fear of physicians has been demonstrated by a recent study, not yet published, about the use of analgesics in emergency setting. It is reasonable to believe that the actual situation in Italy is the consequence of the lack of a specific school on pain therapy and of the teaching of pain therapy in the University, until a few years ago. In this situation, only the scientific societies can obtain results.

A qualitative exploration of living with chronic neuropathic pain after spinal cord injury: an Italian perspective

“…[24] In Italy, chronic pain management is a developing but emergent specialization in healthcare practice. [25,26] Italian healthcare professionals have reported uncertainty about integrating psychological and emotional aspects of patients' pain experience into practice, and have questioned whether patients' descriptions of their pain were a credible indicator of actual pain experience. [27] Practitioners in Italy have also voiced doubts about whether severe pain could be experienced in chronic non-cancer conditions.…”

“…[27] Practitioners in Italy have also voiced doubts about whether severe pain could be experienced in chronic non-cancer conditions. [26] Cultural and professional factors are thought to underpin these views. [26,27] Legislation, introduced between 1990 and 2010, obliged Italian healthcare institutions to establish pain management services, assure citizens' rights to pain treatment and simplified procedures restricting opioid prescription.…”

“…[26] Cultural and professional factors are thought to underpin these views. [26,27] Legislation, introduced between 1990 and 2010, obliged Italian healthcare institutions to establish pain management services, assure citizens' rights to pain treatment and simplified procedures restricting opioid prescription. [28,29] These laws also incorporated components of the biopsychosocial model, such as provision of individual care programs and active participation in decision making.…”

Inadequate cancer pain management in Italian clinical trials

“…Despite implementation of the World Health Organization (WHO) guidelines published in 1998 [8], undertreatment of cancer pain is still present in various clinical settings [9][10][11] with a very high prevalence [12][13][14][15][16]. In Italy, a special law promulgated in 2001 entitled "Hospital without pain" sought to combat the pain in hospitals, but few hospitals, up to 2008, adopted such legislation rules [13]. In order to improve the situation, reporting a complete assessment of pain (type, measurement, treatment, relief degree) in clinical records became compulsory by law [17].…”

Assessing Patient‐Centred Care for Chronic Pain: Validation of a New Research Paradigm

“…Its magnitude in Canada is considerable, with a high prevalence among adults (ranging from 15% to 29%) ( 2 , 3 ). Individuals with chronic pain are more likely to be absent from work ( 4 , 5 ) and consult health professionals frequently ( 6 ), resulting in a considerable economic burden ( 7 , 8 ). Moreover, chronic pain is a complex phenomenon resulting from several factors including biological, psychological and social factors ( 8 ), and treatments must consider all of these aspects simultaneously to be effective ( 9 ).…”