Roberto Latina1, Giustino Varrassi2, Ettore Di Biagio3, Diana Giannarelli4, Francesco Gravante5, Antonella Paladini6, Daniela D'Angelo7, Laura Iacorossi8, Cristina Martella9, Rosaria Alvaro10, Dhurata Ivziku11, Nicola Veronese1, Mario Barbagallo1, Anna Marchetti12, Paolo Notaro13, Irene Terrenato14, Gianfranco Tarsitani15, Maria Grazia De Marinis16. 1. Department of Health Promotion Science, Maternal and Infant Care, Internal Medicine, and Medical Specialities (PROMISE), University of Palermo, Palermo, Italy. 2. Paolo Procacci Foundation, Rome, Italy. 3. Dental Clinic, Rome, Italy. 4. Facility of Epidemiology and Biostatistics, IRCCS Policlinico Gemelli, Rome, Italy. 5. Department of Anaesthesiology, Local Health Authority of Caserta, San Giuseppe Moscati Hospital, Via Gramsci n° 8, 81031, Aversa, Caserta, Italy. francesco.gravante@unicampania.it. 6. Department of MESVA, University of L'Aquila, L'Aquila, Italy. 7. Italian Center of Excellence for Nursing Scholarship, Istituto Superiore di Sanità, Rome, Italy. 8. Department of Nursing & Health Professions, IRRCS Regina Elena, National Cancer Institute, Rome, Italy. 9. Hospital Committees, IRCCS Santa Lucia, Rome, Italy. 10. Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. 11. Department of Nursing Innovation and Development, Campus Bio-Medico University of Rome, Rome, Italy. 12. Research Unit of Nursing Sciences, Campus Bio-Medico University of Rome, Rome, Italy. 13. Pain Medicine Unit, Department of Neuroscience, Territorial Socio-Health Agency Grande Ospedale Metropolitano Niguarda, Milan, Italy. 14. Biostatistics and Bioinformatic Unit, IRRCS Regina Elena, National Cancer Institute, Regina Elena, Rome, Italy. 15. Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy. 16. Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy.
Abstract
INTRODUCTION: Chronic pain is a distressing condition that should be treated in specialized pain clinics. Pain clinics offer a holistic, evidence-based approach, including pharmacological, complementary, and invasive treatments. This study aimed to provide preliminary information regarding chronic pain treatments and identify reasons for accessing an important hub-spoke pain clinic network. METHODS: A retrospective multicenter cross-sectional study was carried out. A total of 1606 patients' records were included. Patients were selected from the 26 pain clinics of a single region in Italy. Univariate and multivariate logistic regression models were used. RESULTS: Multivariate models showed that the use of opioids were considered effective for severe or moderate pain [odds ratio (OR) 0.41; 95% 0.33-0.51], while the use of invasive treatments (OR 2.45; 95% 1.95-3.06) and the use of complementary therapy (OR 1.87; 95% 1.38-2.51) were associated with severe or moderate pain. Overall, age, sex, nonsteroidal anti-inflammatory drugs (NSAID) use, a combination of NSAIDs, complementary therapies, and a combination of opioids and invasive treatments did not seem to be significantly associated with the nature of pain. Multivariate models confirmed that clinical parameters such as the nature of pain, multi-diagnosis, more than one site of pain, treatments, and general practitioner, but not the severity of pain and use of invasive treatments, had an impact on the choice of a pain clinic. CONCLUSION: Opioids are useful in managing moderate or severe chronic pain. Multimodal approaches are used for the management of chronic pain. Moreover, it is not clear how patients are addressed to access different pain clinics (spoke versus hub) networks. More widespread adoption is needed for an interdisciplinary approach to managing chronic pain and adopting guideline recommendations, and rigorous research is required to provide more substantial evidence and support clinical practice.
INTRODUCTION: Chronic pain is a distressing condition that should be treated in specialized pain clinics. Pain clinics offer a holistic, evidence-based approach, including pharmacological, complementary, and invasive treatments. This study aimed to provide preliminary information regarding chronic pain treatments and identify reasons for accessing an important hub-spoke pain clinic network. METHODS: A retrospective multicenter cross-sectional study was carried out. A total of 1606 patients' records were included. Patients were selected from the 26 pain clinics of a single region in Italy. Univariate and multivariate logistic regression models were used. RESULTS: Multivariate models showed that the use of opioids were considered effective for severe or moderate pain [odds ratio (OR) 0.41; 95% 0.33-0.51], while the use of invasive treatments (OR 2.45; 95% 1.95-3.06) and the use of complementary therapy (OR 1.87; 95% 1.38-2.51) were associated with severe or moderate pain. Overall, age, sex, nonsteroidal anti-inflammatory drugs (NSAID) use, a combination of NSAIDs, complementary therapies, and a combination of opioids and invasive treatments did not seem to be significantly associated with the nature of pain. Multivariate models confirmed that clinical parameters such as the nature of pain, multi-diagnosis, more than one site of pain, treatments, and general practitioner, but not the severity of pain and use of invasive treatments, had an impact on the choice of a pain clinic. CONCLUSION: Opioids are useful in managing moderate or severe chronic pain. Multimodal approaches are used for the management of chronic pain. Moreover, it is not clear how patients are addressed to access different pain clinics (spoke versus hub) networks. More widespread adoption is needed for an interdisciplinary approach to managing chronic pain and adopting guideline recommendations, and rigorous research is required to provide more substantial evidence and support clinical practice.
Authors: R Latina; M G De Marinis; G Baglìo; M S Cattaruzza; P Notaro; V Guzzetti; J Osborn; J Sansoni; D Giannarelli; M Piredda; D D'Angelo; C Mastroianni; G Casale; A Gatti; G Tarsitani; P C G Pain Centers Group Journal: Ann Ig Date: 2014 Jul-Aug
Authors: P Notaro; P Nunnari; N Ladiana; M C Montagna; M Lusignani; M Moreno; M Bosio Journal: Eur Rev Med Pharmacol Sci Date: 2021-05 Impact factor: 3.507