Portugal

Implementation fo pain medicine in the Portuguese health care system

Portugal is one of the few European countries that have already implemented pain management in its national healthcare system.

Over the last 12 years significant milestones where achieved in Portugal regarding the improvement of a legal and operational framework towards a better treatment of chronic pain. Back in 1999, a ‘Day Against Pain’ was introduced in order to promote the social awareness of the problem, followed in 2001 by the implementation of the “The National Plan Against Pain”. In 2003, pain was considered as the ‘5th vital sign’ by the Portuguese authorities and one year later, in 2004, pain management was recognized as a medical competence by the National Medical Association.

In 2008, the National Plan Against Pain, initially established in 2001, evolved to the actual National Program for Pain Control, with new objectives and new strategies. In this same year a special reimbursement of 90% for the drugs used for the treatment of chronic pain was approved, which improved the access of patients to the prescribed therapy. In 2010 a national survey was conducted to draw attention to the prevalence of chronic pain in Portugal, over the responsibility of OBSERVADOR, a coalition between the Faculty of Medicine of the Oporto University and the Portuguese Association for the Study of Pain (Portuguese IASP Chapter).

Recently, in 2011, the electronic prescription of drugs for the treatment of chronic pain has entering into force, eliminating the previous bureaucratic procedure applied for the prescription of such drugs.

Notwithstanding there are still room for improvement in the following items that are missing in the National Program: priority financing for basic scientific research, the involvement of patient interest groups in care programs and the adoption of approaches that support self-care.