Updated programme for SIP 2014 panel discussions!
"Societal Impact of Pain Symposium" November 18th - European Parliament
The final program for the SIP 2014 "Societal Impact of Pain" Panel discussions is now online! Please find here more detailed information about the event in the updated programme.
SIP LinkedIn Group membership exceed 2500
The SIP group on the interactive platform "LinkedIn" celebrates its 2nd anniversary. The group on the topic of the "Societal Impact of Pain" was created on 20th November 2010. Since then network has grown to a size of 2.125 members!
Interested in participating in the discussion? Join the SIP LinkedIn Group today!
November 17-18th , 2014
Considering the announcement of the Italian Government in the media that they intend to list Chronic Pain and Palliative Care as Healthcare Priorities during their Presidency of the EU Council in 2014 the SIP programme committee decided to host SIP 2014 in the second half of the year. Please save the dates November 17-18th , 2014 - the event will be hosted in Brussels as usual and more details to follow soon.
Please find here the English transcript of the interview that was broadcasted by an Italian television station towards the end of last year that involves Prof. Guido Fanelli ( President of the Ministry of Health Commission for the application of Law No. 38/10 ) , Giuseppe Casale ( Ministry of Health Commision Law 38/10 - Health Coordinator , Scientific Director of Antea ) and Francesco Bevere ( General Director for Health Planning - Ministry of Health )
Presenter (Moderator): Thank you, Paolo Di Giannantonio, time to call a halt to this ever-present intolerable pain, to this chronic pain, enough, 38 times enough. This is not a rant, but an assertion of a right established by the Italian Law No. 38, 15 March 2010, to protect those who are ill, so that we can banish unnecessary suffering from our hospitals and from our own homes. This is a right that needs proper protection and today we have with us Guido Fanelli, Professor of Anaesthesia and Resuscitation at Parma University, President of the Ministry of Health Commission for the application of this Law No. 38, to talk about the campaign 38 times enough, Professor.
Prof. Guido Fanelli, (President of the Ministry of Health Commission for the application of Law No. 38/10): Good morning, even the opening words of this law are an example of what we should expect. Namely: this law protects the right of all citizens, including children, to access palliative care for pain therapy. This is already important as it highlights the clear difference between palliative care and pain therapy. Keep this in mind as we say that Article 7 of this law obliges all doctors, and also all nurses, to report pain levels in the patient’s medical record (hospital or otherwise), to measure the pain and also the analgesic therapy started and especially the results, whether or not the patient already was suffering pain in hospital.
Presenter: This right has been a long time coming, however, because it deals with….
Prof. Guido Fanelli: But, listen, this is the only law in the Western world dealing with pain. As far as I know there is only Andalusia, an autonomous region, and Washington state. This law, perhaps we will talk about it later, has even been taken as a model of good quality legislation by the European Commission. Two years ago I was at the European Commission to present it and the London School of Medicine came to understand how we made this law.
Presenter: Finally! Perhaps we shall succeed in being the first. Therefore pain will not be just a symptom but will become a pathology to be treated. Giuseppe Casale, Health Coordinator, Scientific Director of Antea, an organisation specialising in this subject, palliative care. True? Is that right? No more symptoms?
Giuseppe Casale, (Ministry of Health Commission Law 38/10 - Health Coordinator, Scientific Director of Antea): Palliative care, pain therapy, and pain have come to be one of the main objectives of palliative care. Obviously pain is not just a symptom, but is a real pathology, in other words it is a disease in the disease. You just have to imagine how invalidating pain can be, people cannot move about, have a proper social life, not even manage to do their shopping.
Presenter: Even the most ordinary daily tasks then.
Giuseppe Casale: Even the most ordinary things. So, at Antea we have promoted this campaign, 38 times enough, precisely to reiterate that there is a law, as Professor Fanelli has said, an extremely forward thinking law, and we are asking loud and clear that this law is enforced, applied in other words, because otherwise the people will continue to be looked after badly and be unable to work day after day and will not be able to live a normal life.
Presenter: Now we know what the law is called. It is time that we try to understand what the law is. We will try to summarise it as not everyone understands, as Professor Fanelli has rightly pointed out, and many more do not know anything about it, most importantly, those people who are meant to enforce it.
Professor Fanelli: Yes, it’s pretty incredible, because it is a law that gives protection against pain, that guarantees access to pain therapy and to palliative care, but the population – and unfortunately even the doctors - barely know anything about it. As we may well know if we have to travel at speeds of 130 on the motorway, we adapt to this, but pain therapy is still a challenge. One of the most important things we thought we would do when this law was enacted is to make the GP the first point of contact. I mean, a patient who is in pain, and we’re talking about chronic pain here, pain that has gone beyond 3 – 6 months from moderate to severe; we are not talking about trivial pain. From this perspective the General Practitioner is our first gatekeeper. Then, the next step, the more technical part, the patient will be directed to the hospital. We are talking about chronic pain here, even the sort of pain that can be termed benign pain. We are not only dealing with malignant chronic pain, like cancer for example, which fortunately is only a very small percentage, 5 – 6 – 7%. We are talking about chronic benign pain. Colloquially known as back pain, and I think that in this studio there are many people who would raise their hands to that….
Presenter: Well, yes, because working from the early morning our operatives, who are standing all the time, God forbid, know very well that this causes back pain.
Professor Fanelli: I believe that a very recent study has shown that the total cost of back pain in the UK is 7% of GDP.
Presenter: So let’s think …. how it influences …. Then Prof. Casale, ‘38 Times Enough’ is not only our right that we must claim, but it is also a very important campaign. Can you explain that?
Giuseppe Casale: We believe this campaign must reach everybody, as they all have the right not to suffer; and it’s a campaign that affects more than 15 million people in Italy who suffer from chronic pain. As we said earlier, it is back pain, but just think about sciatica, lower back sciatic pain, there is a lot of that. The campaign will raise awareness using the pharmacies, at this point we are starting in Rome but the campaign will be promoted at national level, to raise awareness within the population, because they must know about their right not to suffer.
Presenter: www.38voltebasta.it, this is the address for finding out more.
Giuseppe Casale: Yes, thank you. At present pain is not treated in an appropriate way, because the doctors are not taught, unfortunately, to provide pain therapy in an adequate manner; and this is exactly why we are seeking to raise awareness so that the population will say: “OK, I want to be cured”. It is absurd that a patient suffering from chronic pain will only see a pain specialist after suffering for 4-5 years.
Presenter: Precisely, exactly as Prof. Fanelli said, the first step should be the GP. An important contribution from Chiara del Gaudio with the director Antonio Morabito, then we will come back to the subject of pain therapy.
Chiara del Gaudio (Journalist/Moderator): Francesco Bevere is the General Director for Health Planning at the Ministry of Health. The first thing we need to know: Professor, why is there so much disparity in the application of Law 38 to fight unnecessary pain?
Francesco Bevere (General Director for Health Planning - Ministry of Health): Yes, in fact, it is unevenly promoted across the country and that is fixed by the reform of Title V of the Constitution. The regions, as we know, have the utmost autonomy when it comes to health service management, on one hand this is a huge benefit, as the population’s requirements can be figured out for each territory, but on the other hand this means that the system will have – let’s say – various models and therefore the application of the law is more advanced in some regions and a little bit behind in some others.
Chiara del Gaudio: Could they not just be fined then, as is actually provided for in Law 38?
Francesco Bevere: We will do it in fact. The regions who do not comply will be fined. The Ministry is scrutinising this via 2 monitoring organisations, these are the LEA National Committee, who deal with the care components, and the National Commission for Palliative Care. Therefore, every year we know which regions have fulfilled their requirements according to Law 38, and which others still require follow through. The problem is certainly also cultural, as these are not always issues that can be resolved with financial resources. We are driving forward planning at the national level by putting the individual’s needs at the centre and understanding how important this is, as well as initiating more sophisticated and appropriate care pathways, to accompany people at a very difficult time in their lives, such as when they are suffering, with a little more hope, serenity, and above all generosity, giving them more justice for their treatment, especially under some conditions.
Chiara del Gaudio: On 1st July 2014 Italy takes over the EU presidency. What room will be given to this health emergency?
Francesco Bevere: We will be foregrounding it, obviously. Law 38 is an example to everyone else, it is recognised as outstanding. We are the first in Europe, and we certainly want to remain so, indeed the Minister has given it priority, recently Minister Lorenzin has given priority to the issue of pain, ensuring it will be one of the topics addressed during Italy’s Presidency of the EU.
Chiara del Gaudio: Thank you Francesco Bevere. We will conclude with the words of Ian Semmons, the patient who founded “Action on Pain” in Great Britain: “We must push for access to innovative therapies, to ensure that chronic pain sufferers everywhere get to live the life they deserve”. This is a call that should not go unheeded.
Presenter: And we are here to make sure this happens. Thank you Chiara del Gaudio.
Presenter (Moderator): So, Dr. Casale, can we now discuss the use of opiates or opioids, the opiate derivatives, what they are and how they are used in the treatment of pain.
Giuseppe Casale: The World Health Organization recognises these drugs as the most useful for the treatment of pain. In Italy there is currently a very high consumption of NSAIDs, these are the anti-pain drugs we all know and many of you watching will be taking these, however little is known of their side effects. Opiates on the other hand have very few. The truth is that in Italy we are one of the lowest consumers of opiates and opioids, but one of the greatest consumers of NSAIDs. The side effects of long term NSAIDs use include heart and liver damage. Damage that should not be taken lightly. Unfortunately this is not explained properly, because we are afraid. This is why we have created this campaign. We are afraid to use them.
Presenter: A very important point, so to end this discussion, what other possibilities do patients have.
Prof. Fanelli: I would like to finish talking about opioids, as this is very important. Because, in 2007, in Italy, opioid consumption was 0.67 per capita. After Law 38 it is at 1.30. Not much. In Spain, a culturally similar country, it is 3 euros. And Germany, it is at 10 euros. This is somewhat culturally driven, where morphine – derived from opioids – is seen as something to fear, even by doctors. Presenter: A dangerous thing, a negative thing. However, we have discovered that it is a very useful and specific substance, with few side effects compared with other substances.
Prof. Fanelli: Basically, with the new drugs we have today, if they are used with care, they have no side effects, even less than NSAIDs. Other devices that can be used …. when you look at the opiate-phobia we have in Italy, because this is one of the most important things. For example the classic back pain, also called sciatica, you can see the possibilities for treating diseases of the spine with implants providing spinal cord stimulation. This should be used as a last resort, when all the drug treatments have failed. Most importantly back pain is responsible for 500 million working days lost in the United States.
Presenter: It will always have an effect on GDP, as we have already mentioned. In short, chronic pain and cancer pain should be treated, they are two different things, and should be treated in different ways?
Giuseppe Casale: No, pain is always pain. Obviously, there is the so-called benign pain, caused by chronic diseases such as arthritis, but they should both be treated in the same way.
Presenter: This is a very important point, let’s reiterate that for all our viewers: if you are in pain, go and see your doctor and ask them for treatment for that pain, because you should never have to tolerate pain, it is not right.
Presenter: Thank you Guido Fanelli, thank you Dr. Giuseppe Casale and don’t forget this IN TOUR initiative by Antea on 18thNovember. TG1
Did you miss SIP 2013 Focus Groups? No problem!
1st national SIP steering group meeting in Switzerland
The impact of SIP 2011 a "Road Map for Action" on Switzerland
Following the successful 2nd SIP Symposium in the EU Parliament in Brussels last year, Professor Eli Alon, President of the Swiss Association for the Study of Pain (SGSS), held a press conference in Zurich 16.07.2011 where he informed about the “Road Map for Action” and its seven policy dimensions for an improved pain care in Europe.[
According to dimension No 6, which calls for the development of national SIP platforms in the European Member States, a first Swiss SIP steering group meeting took place in Zurich on 6 September 2012.
15 stakeholders from medicine, politics, academia and the health system were invited to a brainstorming meeting and for deep discussion on chronic pain treatment in Switzerland. Professor Kress, President of EFIC®, gave an overview of the last three SIP Symposia from 2010 to 2012 and the aims of European platform.
- The first and most important topic in Switzerland is the fact that there is no title or diploma for doctors who are specialists for pain diagnosis and treatment. Since several years the goal of the SGSS has been to achieve an official status as pain specialist. The discussion during this meeting showed that the topic is still of utmost relevance for all stakeholders.
- The second topic was about “best practice”: On the one hand the quality of pain therapists has to be built (medical education at universities) and maintained (quality control, credits, etc.); on the other hand clear treatment guidelines have to be defined.
- The third topic was “pain research”. At the moment over 50 groups do research on pain therapy; in addition there is an alliance of four Swiss university clinics which coordinates studies at this level. The aim of the SGSS in the future will be to be involved in choosing research-topics to improve the general knowledge in pain disorders and treatment possibilities.
Further ideas and topics were discussed. The second follow-up Swiss SIP steering group meeting is planned for spring 2013.
More than 2000 Members in SIP LinkedIn group
With a constant growth the SIP LinkedIn group on the "Societal Impact of Pain" now counts more than 2000 members!
One year ago in August 2011, the SIP LinkedIn group counted 883 members and was ranking second on the international list of pain related groups within the LinkedIn network. Now, after exactly one year, the number of members increased by 130% - with about 2017 members (status: 21.08.2012) it still is the first runner-up in pain related networks.
The platform is larger than "Pain physician", with 1675 members (by Janssen-Cilag-JnJ Group), as well as the "American Pain Society", counting 1950 members. The leading pain related group is "Therapeutic Massage for Pain Control" with a total of 2770 members.
Driving force behind is the group members themselves: With statements, comments and discussions they focus on different perspectives of the influence of pain on our societies, our economic and social systems as well as the individual situation of millions of pain patients worldwide.
Become a member of SIP LinkedIn group now!
EU Parliament EULAR Interest Group: RMDs & Pain
Rheumatic / Musculoskeletal Diseases & Pain
On 26 June there took place the 9th Interest Group on Rheumatic and Musculoskeletal Diseases in the European Parliament with special focus on pain: "RMDs and Pain: Facts and Findings".
Chaired by Irish MEP Jim Higgins, Professor Giustino Varrassi (past president EFIC), Mr Joop van Griensven (President of the Pain Alliance Europe, PAE), and Mr Neil Betteridge (Vice President of EULAR, representing People with Arthritis/Rheumatism in Europe, PARE) shared their insights on the topic and stirred-up the discussion which followed.
Here you can find the EULAR IG meeting agenda.
Here you can find the EULAR IG meeting minutes.
Here you can find the presentation by PAE president Joop van Griensven.
Here you can find the presentation by VP EULAR Neil Betteridge.
SIP 2012 Photos, Videos, Presentations online!
Please now find online SIP speakers´ presentations, videos and statements, as well as photo impressions from the whole symposium!
Final Program Dansk Satellitsymposium online!
"Danish Satellite Symposium - 29 May 13:00 - 17:00"
On 29 May the Danish language symposium will be held. This event will start at 13:00. The current situation of chronic pain will be discussed, as well as how it should be, the future and how we should proceed. At the end a panel discussion will be held from 16:00 - 17:00. For more detailed information, please find here the final program.
Program of SIP 2012 and the Danish Satellite Symposium - now online!
View the SIP and Danish Satellite Symposium programs!
The most recently updated versions of the SIP 2012 program (29 - 31 May) and the program of the Danish Satellite Symposium (29 May) are now online!
Please click here for the draft program of the full SIP Symposium, to be held on 29 - 31 May 2012.
Please click here for the draft program of the Danish Satellite Symposium, to be held on 29 May.
EFIC Newsletter - now published!
The first 2012 edition of the EFIC newsletter has now been published with information on:
- The President’s Corner
- A Word from the Editor
- "The Societal Impact of Pain”
- EWAP 2011: Chronic Back Pain
- EFIC Pain Schools: Past, Present and Future
- The EFIC Pain School Montescano
- Ethics in Pain Medicine
- Chronic Pain: A Disease in its Own Right
- Meetings: Past & Future
Read here the full edition of the EFIC Newsletter Vol.1 2012.
New SIP Press Release published
Chronic Pain as Disease – Politics or Science?
International multi-stakeholder platform to discuss the position of chronic pain amongst chronic diseases - 3rd European symposium on the “Societal Impact of Pain” (SIP) taking place during Danish EU Presidency in Copenhagen
Brussels, 20 March, 2012. The 3rd European symposium on the “Societal Impact of Pain” (SIP 2012) will take place in Copenhagen, Denmark on 29-31 May. On the occasion of the Danish EU Presidency, more than 300 stakeholders from across Europe will come together to continue raising awareness on the societal impact of pain, exchanging national best practices of pain care policy projects and fostering the EU-wide implementation of the “Road Map for Action”, the action plan and key result from the 2nd SIP symposium, which took place in the EU Parliament in Brussels in 2011.
Read the full SIP 2012 Press Release.
New SIP RSS-Feed implemented
Starting today you now have the option to get free RSS-feeds on all three SIP news sections in your inbox.
The screenshot below shows you where to find the RSS-feed. In case you need any assistance in installing these, please contact us.
What about pain care in...Europe?
Monitor on national pain care in EU-countries
Most of us know what it is like to have pain and to go to a doctor for getting medication, physiotherapy or other treatments. What most of us are not aware of is how pain is being managed in other countries of Europe. Will a GP prescribe a pain drug in UK? Are physicians specially trained for treating pain patients in Spain? Do patients have access to pain specialists in Portugal? Do politicians recognise the need for pain care in Italy? Is pain care in Scandinavia really better than in southern-EU countries?
Together with the European umbrella organisation for the study of pain (EFIC®), Grünenthal Governmenthal Affairs & Health Policy has developed a European Monitor to give a quick and country-specific overview of the situation of pain care in most European countries.
Please view the full European Road Map Monitor 2011.
SIP 2012 on official calender of Danish EU Presidency
Societal Impact of Pain - konference om kroniske smerter
For tredje år i træk afholder den europæiske forening for smertespecialister (EFIC) og Foreningen af Kronisk Smertepatienter (FAKS) en tværsektoriel konference om kroniske smerter, ”Societal Impact of Pain”. Konference giver mulighed at diskutere og udarbejde forslag til, hvordan man kan gribe de udfordringer, som kroniske smerter giver, an. Konferencen er opbygget således, at der er rig mulighed for interaktion og dialog. Således indledes konferencen med to dages møder for særlige interessegrupper og workshops. På de forskellige workshops får deltagerne mulighed for at fordybe sig i dialog omkring et specifikt emne.
For the official announcement in full English on the SIP 2012 symposim, please go to the website of the Danish Presidency.
SIP 2012 "Marketplace" - Option to exhibit materials
On 30 and 31 May 2012 in the Bella Sky Congress Hall Foyer, a SIP 2012 "Marketplace" will be held. This is an informal area where our SIP partners and stakeholders can present stakeholder materials and get in contact with other participants. No commercial promotion or products may be displayed during the Marketplace. All items that are displayed must be topics related to the Societal Impact of Pain.
For more detailed information about the setup, please click on this document.
The scientific aims of SIP 2012 are endorsed by more than 40 organisations
The scientific aims of SIP 2012 are endorsed by more than 40 organizations
Up to today the scientific aims of SIP 2012 are already endorsed by more than 40 pain advocacy groups and patient organizations. If you would like to become an endorsing organisation and endorse the scientific aims of the 3rd European Symposium on the "Societal Impact of Pain" (SIP 2012) too, please contact the SIP 2012 committee.
SIP 2012 to take place in Copenhagen
Save the Date: 3rd European Symposium on the "Societal Impact of Pain"
Following the great success from SIP 2011 in the EU Parliament/Brussels, the mission of the European Platform "Societal Impact of Pain" for an improved pain care in Europe is continuing: Next year the 3rd European SIP symposium will be held in Copenhagen, Denmark. Please block your calender from Tuesday, 29 May - Thursday, 31 May.
For more information on SIP 2012, please see the official SIP 2012 announcment.
EU Commissioner John Dalli supports SIP
"Managing pain correctly"
As Commissioner Dalli stated during the 2nd European symposium on the Societal Impact of Pain held in the European Parliament in Brussels on 3 and 4 May, ‘we need to understand pain better and manage it correctly’, especially in the context of an ageing society. Read the full transkription of John Dalli's opening speech during the SIP symosium in the EU Parliament on 3 May.
The Commission recently launched the Active and Healthy Ageing Partnership. Moreover, the Council has called upon the Commission to conduct a reflection process about what Europe can do to address chronic diseases by 2012.
SIP - A Road Map for Action
Tackling chronic pain in Europe on policy level
During the 2nd symposium on the "Societal Impact of Pain", which took place in the European Parliament in Brussels on 3-4 May 2011, a "Road Map for Action" was adpoted and officially presented to Members of the European Parliament and the EU Commission.
The policy instrument lists seven concrete policy dimensions on how to tackle chronic pain in Europe. It is directed towards the EU institutions, as well as towards governmens and decision-makers of EU Member States. More information you can find in the corresponding SIP symposium press release.
1. Acknowledgement of pain as an important factor limiting the quality of life;
2. Availability of information and access to pain diagnosis and management;
3. Increased awareness of the medical, financial and social impact that pain and its management have;
4. Increased awareness of the importance of prevention, diagnosis and management of pain;
5. Enforcement of pain research;
6. Establishment an EU platform for the exchange, comparison and benchmarking of best practices;
7. Trend monitoring in pain management by using the EU platform.
Here you can find the complete Road Map for Action.