Madrid, December 2, 2022. The Weber Foundation, in collaboration with Ferrer, presented on November 30 at the Official College of Physicians of Madrid the main results of the White Paper on Chronic Pain in Spain. In addition, the challenges in addressing chronic pain were analyzed and possible solutions to overcome them were discussed. Through a holistic and realistic vision, where we are were explained and possible ways of improvement were assessed to determine where we are going. This book is intended for professionals of the National Health System of the different specialties involved in the management of patients with Chronic Pain, political and health management managers, patient associations and their constituents and anyone with an interest in the field of Chronic Pain.
Pain, in addition to being a symptom, is a disease that requires a holistic care model, which moves from a biomedical version to a new biopsychosocial modality. Additionally, the demand for pain care shows a growing trend due to the aging of the population and a high prevalence of chronic diseases. All this implies important challenges for our NHS and for health professionals. Therefore, this book aims to contribute to the improvement of the comprehensive approach to Chronic Pain in Spain, offering recommendations for action from the point of view of care, economic and social.
The Presentation Day presented the work carried out by the multidisciplinary team of experts and was divided into two discussion tables: 1) the care aspects in the approach to Chronic Pain in Spain; and 2) the socioeconomic aspects in the approach to Chronic Pain in Spain. The opening ceremony was made up of Dr. Cristóbal Belda, general director of the Carlos III Health Institute and writer of the book's prologue; Mr. Álvaro Hidalgo, president of the Weber Foundation; and Ms. Arancha Real, Market Access Manager at Ferrer. For the closing, we had Dr. Alberto Pardo, Deputy Director General of Healthcare Quality, DG of Humanization and Patient Care at the Ministry of Health of Madrid.
The concept of "pain" has evolved over the last decade, so that the classic biomedical view of pain has become a complex and multidimensional problem. In the words of Dr. Cristóbal Belda, "pain, in its physical and psychological dimension, limits people's daily activity and autonomy. It is a symptom that often becomes the center of the disease, becoming confused with it. Nothing would make sense, in this book and in the health approach in general, without the participation of people, who are the path and destination of any modification, reflection or incorporation within the National Health System".
The results of the studies reviewed in the chapters on socioeconomic burden indicate that chronic pain has a very relevant impact, both in Spain and in other countries. Dr. Álvaro Hidalgo stated that "the findings demonstrate not only the importance of the costs assumed by health systems, but that the productivity losses associated with chronic pain can be a very significant item, sometimes even above the direct health costs."
In the words of Ms. Arancha Real, "for Ferrer, whose purpose is none other than to generate a positive impact on society, it is a privilege to promote the development of this type of research work that allows us to improve the knowledge of diseases in order to move forward together towards improving their approach and, ultimately, contribute to improving the quality of life of patients with chronic pain in Spain".
Healthcare aspects in the approach to Chronic Pain in Spain
This first table, moderated by Dr. María Madariaga, president of the Spanish Pain Society, included the intervention of Dr. Concepción Pérez, head of the Pain Unit at the Hospital de La Princesa (Madrid); Dr. Jordi Trelis, president of the Catalan Society of Palliative Care; and Dr. Inmaculada Mediavilla, president of the Spanish Society of Healthcare Quality.
The treatment of Pain, currently, can only be conceived from a multidisciplinary perspective, so we must promote the creation of multidisciplinary teams. For her part, Dr. Concepción Pérez assured that "the Pain Units are an essential element in the care of patients with complex oncological pain or not, so it is essential to work on the extension of these to all the Hospitals of the NHS". To improve access to Pain Units, a review of the criteria for direct referral and a better connection between Primary Care services and Pain Units is required.
The main challenge for the care model in the treatment of chronic pain is to explore the genuine expectations and needs of patients in order to meet and/or respond to them. In this sense, it is vitally important to look for person-centred models of care. In the words of Dr. Inmaculada Mediavilla: "it is essential to approach the assessment of the patient in a personalized way and integrating the bio-psycho-social dimensions, as well as to evaluate the effectiveness of our actions to improve them". In addition, Dr. Jordi Trelis added that "care for patients with chronic pain has to be transversal, accessible, non-sectorized, protocolized and have specific action plans."
Socioeconomic aspects in the approach to Chronic Pain in Spain
The second round table, moderated by Dr. Ignacio Velázquez Rivera, treasurer of the Spanish Multidisciplinary Pain Society (SEMDOR), was formed by Ms. María Merino, director of the Department of Health Outcomes at Weber; Dr. Álvaro Hidalgo, president of the Weber Foundation; and Mr. Andoni Lorenzo, president of the Spanish Patients' Forum.
The degree of patient satisfaction with the care and treatment received decreases depending on the degree of pain intensity. Therefore, Dr. Ignacio Velázquez Rivera, from a social perspective, believes that "it is necessary to have instruments for classifying and determining the intensity of pain as rigorous as possible, in order to offer personalized care." For her part, Ms. María Merino added that "a change of perspective is necessary in the way chronic pain is analysed and managed in order to achieve the sustainability of the system, not only health but also social".
Taking into account the dignity and opinion of the patient in therapeutic decisions must be a central element. To this end, the autonomy of patients must be enhanced and Mr. Andoni Lorenzo considers that "guidelines for action or recommendations to continue patient care by Primary Care doctors must be provided and alliances must be created with associations of patients with diseases that are in pain to ensure that the information reaches patients and their families in an effective and affective way".
Before delivering the book to all attendees and members, Dr. Alberto Pardo gave the following closing words: "This Book implies new challenges for health systems and also for health professionals. Proof of this is the development of institutional strategies and the creation of pain care committees."
To see the Presentation Day, access through this link.
