R Latina1, M G De Marinis2, G Baglìo3, M S Cattaruzza1, P Notaro4, V Guzzetti5, J Osborn1, J Sansoni1, D Giannarelli6, M Piredda2, D D'Angelo7, C Mastroianni8, G Casale8, A Gatti9, G Tarsitani1, P C G Pain Centers Group10. 1. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy. 2. Department of Nursing, Campus-Bio-Medico University, Rome, Italy. 3. Agency for Public Health of Lazio Region, Rome, Italy. 4. Pain Center, Niguarda Cà Granda Hospital, Milan, Italy. 5. Nopain Onlus, Milan, Italy. 6. Service of Biostatistics, Research Institute of IFO Regina Elena, Rome, Italy. 7. Doctoral School of Nursing Science, Tor Vergata University, Rome, Italy. 8. Antea ad Palliative Care Hospice, Rome, Italy. 9. Pain Center, Tor Vergata Univesity, Rome, Italy. 10. PCG (Pain Centers Group): Adducci E, Arcioni R, Bertini L, Bisbiglia C, Bonfigli R, Bosco M, Capogrossi M, Colini Baldeschi G, De Meo MA, D'Este G, Diamanti P, Di Donato A, D'Orazio L, Fabroni S, Gagliardi A, Laganà S, La Placa E, Mattozzi I, Montone G, Natalini L, Orsetti R, Proietti R, Rabuffi G, Reale C, Rinaldi R, Siena G, Spaziani S, Stefani M, Quadrino L.
Abstract
BACKGROUND: Evidence on pain management highlights the importance of a multidisciplinary approach in order to achieve optimal therapeutic results. Such programs can be guaranteed by the Centers for Pain Management (CPMs), in which multidisciplinary teams are able to provide advanced and specialized activities for the assessment, diagnosis and treatment of chronic benign pain. To date, information related to healthcare supply and the organizational structure of these centers in Italy is incomplete. The aim of this paper was to provide an overview of the healthcare network of the CPMs in the Lazio region. METHODS: A descriptive survey was conducted in all the 37 CPMs existing in the Lazio region in 2011 of which 28 participated. RESULTS: CPMs were located either in Universities or in public or private hospital facilities. They included a clinic, a Day Hospital service, Day surgery and day-beds. CPMs were managed by anaesthesiologists who, in most instances, did not work in a multidisciplinary team. The number of other health professionals available, such as nurses, psychologists and physiotherapists, was limited. CPMs mainly provided drug therapy, Complementary Alternative Medicine (CAM) and complex interventional treatments. The median waiting time was 30 days. The clinics were not homogeneously distributed in the region with a higher concentration in Rome (56%), followed by other provinces of the Lazio region (26%) and the province of Rome (18%). Clearly, Rome was the city which offered the greatest range of healthcare services and the highest number of consultations with patients, which significantly differed from those of the other areas (χ²=19.6 p<0.01). CONCLUSIONS: In 2011, the availability of CPMs was not equally distributed throughout the territory, and there was an over-utilization of the facilities in Rome and an under-utilization in the provincial areas. Moreover, this study showed a lack of a multi-professional approach to chronic pain management.
BACKGROUND: Evidence on pain management highlights the importance of a multidisciplinary approach in order to achieve optimal therapeutic results. Such programs can be guaranteed by the Centers for Pain Management (CPMs), in which multidisciplinary teams are able to provide advanced and specialized activities for the assessment, diagnosis and treatment of chronic benign pain. To date, information related to healthcare supply and the organizational structure of these centers in Italy is incomplete. The aim of this paper was to provide an overview of the healthcare network of the CPMs in the Lazio region. METHODS: A descriptive survey was conducted in all the 37 CPMs existing in the Lazio region in 2011 of which 28 participated. RESULTS: CPMs were located either in Universities or in public or private hospital facilities. They included a clinic, a Day Hospital service, Day surgery and day-beds. CPMs were managed by anaesthesiologists who, in most instances, did not work in a multidisciplinary team. The number of other health professionals available, such as nurses, psychologists and physiotherapists, was limited. CPMs mainly provided drug therapy, Complementary Alternative Medicine (CAM) and complex interventional treatments. The median waiting time was 30 days. The clinics were not homogeneously distributed in the region with a higher concentration in Rome (56%), followed by other provinces of the Lazio region (26%) and the province of Rome (18%). Clearly, Rome was the city which offered the greatest range of healthcare services and the highest number of consultations with patients, which significantly differed from those of the other areas (χ²=19.6 p<0.01). CONCLUSIONS: In 2011, the availability of CPMs was not equally distributed throughout the territory, and there was an over-utilization of the facilities in Rome and an under-utilization in the provincial areas. Moreover, this study showed a lack of a multi-professional approach to chronic pain management.