5th Symposium on the Societal Impact of Pain (SIP), Brussels, 18th November 2014
European advocates call for EU action in the creation of a European Network for palliative care and pain therapy focusing on training of professionals and sharing of best practice.
Brussels, 18th November 2014. Better education on pain management and the need to foster European best practice sharing was discussed at the 5th Symposium on the Societal Impact of Pain (SIP), endorsed an international multi stakeholder platform aimed at raising awareness for the impact that pain has on our societies, health and economic systems. Pain therapy and palliative care were listed as a priority by the Italian Presidency of the EU Council and, for the first time ever, all EU ministers of health discussed this topic at the recent informal Health Council meeting in September. Delegates of the SIP symposium, endorsed by the Italian Ministry of Health, welcomed the EU health ministers’ decision to create a European network for the training of healthcare professionals and the sharing of information and best practices[i]. They discussed what measures are urgently required to ensure that pain therapy and palliative care remain priorities on the agenda of both the EU institutions and national governments. European countries should benefit from existing good practices to avoid inequalities in access to pain treatment and the Commission and member states should secure the necessary resources to ensure that such a network is put in place for the benefit of European patients, especially considering the needs of both the elderly and paediatric patients.
Italian Minister of Health Beatrice Lorenzin, commenting on the Symposium, referred to law 38/2010[ii] which ensures access to pain therapies in Italy and said: “Member states should consider developing public health strategies that include effective policies on pain therapy and palliative care, for which Italy is a good example”. Minister Lorenzin also pointed out the need to ensure access to all currently available treatments and to reduce the existing inequalities between regions and EU member states. “Upholding the right of the patients to avoid unnecessary suffering and pain should be a national and European priority” she said.
Willem Scholten, former WHO officer echoed the call by the Italian Minister of Health. “Opioid analgesics are considered essential medicines by the WHO” – he reminded the audience – “and they are indispensable for the treatment of moderate to severe pain. However, policies ensuring access to this kind of treatment are not equally present throughout Europe”. Participants recognised the need for EU member states to equally apply the 2011 WHO Policy Guidelines for Controlled Substances[iii], which help identify appropriate policies with regards to availability, accessibility, affordability and control of medicines, such as opioids. The exchange of best practice in this field could help countries improve management of controlled substances and avoid the social consequences of misuse.
Chronic pain affects almost 100 million European citizens and 50% of the older population in Europe[iv]. All in all, chronic pain causes 500 million days of illness per year in Europe, costing the European economy more than €34 billion[v]. Dr. Chris Wells, President of the European Pain Federation EFIC® pointed out that "Better early management of pain, especially back pain, could produce a huge cost saving and a reduction in sick leave and disability".
Depression, anxiety, reduced physical mobility, and social isolation are frequently related to chronic pain conditions[vi]. Depression and back pain are two of the top five causes of disability in every region of Europe[vii]. And yet, 82% of undergraduate medical schools in Europe have no dedicated courses on pain that are compulsory for all students[viii]. The effects on European society are considerable, chronic pain being one of the major reasons why people exit the labour market prematurelyvi. “We therefore need to put much more emphasis on the education of young professionals when it comes to pain and palliative care. The topic must receive more attention in the curricula of medical education in Europe and the world”, concludes Prof. Dr. Hans-Georg Kress, past president of EFIC®.
The scientific framework of the SIP platform is under the responsibility of the European Pain Federation (EFIC®). The pharmaceutical company Grünenthal GmbH is responsible for funding and non-financial support (e.g. logistical support).
[i] Summary of the conclusions of EU Health Ministers meeting in Milan, 23 September 2014: http://italia2014.eu/en/news/post/conclusioni-informale-salute/
[iii] World Health Organization (WHO), Ensuring Balance in National Policies on Controlled Substances, Guidance for availability and accessibility of controlled medicines, Geneva, 2011. ISBN 978 92 4 156417 5 (http://www.who.int/medicines/areas/quality_safety/guide_nocp_sanend/en/)
[iv] Breivik H, Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment, Eur J Pain 2006; 10 (4): 287-333 (http://www.ncbi.nlm.nih.gov/pubmed/16095934)
[v] Hill L. et al., Recent advances in the pharmaceutical management of pain, Expert Rev. Clin. Pharmacol. 2(5), 2009, 543-557
[vi] Phillips C, Main C, Buck R, Aylward M, Whynne-Jones G, Farr A., Prioritising pain in policy making: The need for a whole systems perspective, Health Policy 88, 2008, 166-175
[vii] Murray CJL et al. Lancet. 2012;380(9859) :2197-223
[viii] European Pain Federation (EFIC), Advancing the Provision of Pain Education and Learning (APPEAL), October 2013: http://www.efic.org/userfiles/APPEALmediareport.pdf