SIP 2017 - Key Statement
Prof. Dr. Boaz Gedaliahu Samolsky Dekel – No Pain Foundation, Malta
"Free access to pain facilities, medications and treatments, sharing best-practices across the EU and the awareness of the relevance of pain’s impact on our societies, social, health and economic systems are lacking. Individual’s comprehensive needs should be the center of each curative approach."
Prof. Dr. Boaz Gedaliahu Samolsky Dekel
No Pain Foundation
Chronic pain (CP) is a spectrum that entails comorbid neuropsychological and social manifestations; its expression depends upon genetic, environmental, and lifespan experiential interactions, and thus establishes individual patterns of physiological, cognitive, emotional, and behavioral responses; all these, in an encompassing approach, should be considered by the clinician to direct the best, technically right, and morally sound, course of care and to meet the patients’ needs and values.
Moderate/severe CP occurs in 19% of European adults, seriously affecting their daily, social and working lives. Most patients do not receive pain treatment, and 40% receive treatment that is inadequate. Moreover, there are no clear guidelines to determine when and how to refer CP patients to secondary or tertiary health-care providers.
A prognostic model may be a tool for CP patients screening and referring to different proficiency facilities of CP management. Prognosis refers to the risk of future health outcomes in people with a given health condition. A prognostic model can influence patient outcome or the cost-effectiveness of care when changes in clinical management are made based on the prognostic information provided. It is the core of the so called ‘stratified medicine’, which is central to the progress of health care. It refers to the targeting of treatments and making the best decisions according to the risk characteristics shared by sub-groups of patients. Indeed, it was reported that adequate patient selection by health care professionals, interdisciplinary assessments and severity adapted treatments resulted in significant reduction in pain and functional improvement in disabled back pain patients. Moreover, outcome prediction, as a function of pain-chronicity stage, may allow patients and professionals to formulate a management plan and to identify risks for poor prognosis. Prediction rules showing good performance may change physicians’ decisions, improve clinically relevant process parameters, improve patient outcome and reduce costs.
Dr. Samolsky Dekel, MD, PhD is the Scientific Director of NoPain Foundation, Malta. He is an Aggregate Professor and Investigator of Anaesthesia, Intensive care and Pain Medicine at the department of Medical and Surgical Sciences of the University of Bologna, Italy.
Senior Anaesthesia, Intensive care and Pain Medicine Consultant at the University of Bologna Teaching Hospital Policlinic S. Orsola Malpighi; the Hospital’s inpatients Acute Pain Service and the Centre of Pain Therapy for outpatients with chronic pain.
Fields of interest and research: postoperative pain, chronic pain evaluation and treatment, opioids for chronic pain, cancer and breakthrough pain, pain in high risk persons.