National Initiatives Italy

In this section, national initiatives which have been set up in Italy can be found.

April 2016: Against pain, an "Hippocratic Oath" for doctors of all specialties

In April 2016, Italian doctors have released a set of ten commitments to treat their patient’s pain, the “Commitment against pain, manifesto of the Italian doctors”.

The set of commitments, which have been handed over to Pope Francis and presented at the United Nations General Assembly, aims to ensure that equality in access to pain care becomes a worldwide priority at health, humanitarian and ethical level.

The ten commitments are addressed to doctors of all specialties.

The Decalogue

I. I am a doctor and respect the Hippocratic Oath

II. I have to treat pain

III. I must take care of the suffering that comes from pain

IV. I have to work for the wellness of the person

V. I have to consider essential the quality of care

VI. I have to commit myself to ensure that access to care to all people is guaranteed, wherever they are born and live 

VII. I have to avoid inequalities and treat all people, regardless of age, gender, ethnicity and religion

VIII. I have to base treatment decisions on the respect of the will of the person and in defence of human dignity

IX. I have to share and promote the knowledge on pain care

X. This is my commitment to improving the quality of life of people with pain


The “Commitment against pain, manifesto of the Italian doctors” can be read here, in Italian only.

A press release on the presentation to the Pope and the UN General Assembly is available here, in Itlaian only.

The initiative has been developed thanks to an unconditional grant by Grünenthal Italy.

30 May - 1 June 2013: 36th National Congress of AISD

"New Frontiers in Pain Medicine" National Congress of AISDThe 36 th National Congress of the "Italian Association for the Study of Pain" will take place on May 30 - June 1st in Verona under the topic: New Frontiers in Pain Medicine.

For further information on AISD look into our SIP 2012 Abstract and Background Booklet or the AISD Homepage!

12 October 2013: European Day against Pain

Since 2011, ISAL Foundation organizes the National Day against Pain in Italy. This year, with the agreement of important cities in Great Britain, Germany, The Netherlands, Spain and Portugal, this important event has reached a continental dimension becoming the European Day against Pain.

This is a very important step that significantly intensifies ISAL Foundation relationships with the world, underling the necessity to create an even stronger network in the territory with an increasing number of different experiences.

This represents also the concrete start point for the realization of the 1st Chronic Pain Research and Therapy European Institute.

For more information on the European Day against Pain, please have a look into the flyer or the website of Fondazione ISAL. Please also read the flyer on the first chronic pain call centre.

October 2012: New booklet "In-Dolore" for chronic pain patients

tl_files/redakteur-bereich/National Initiatives/Italy/In-Dolore_FrontScreenshot_2.PNGThis 32-page practical guide is published by the Italian organization “Cittadinanzattiva” to provide all the necessary information to face pain.

This campaign is carried out by Cittadinanzattiva, the Italian foundation ISAL and the German pharmaceutical company Grünenthal and was additionally developed with the most important scientific societies and associations under the sponsorship of the Ministry of Health. This practical guide, adjusted to citizens needs, explains:

  • how to manage pain
  • where to find information
  • what the citizens have the right to ask in terms of pain care and
  • enlighten citizens on therapeutic treatment options and
  • discredit the legend that opioids or morphine-based products are dangerous.

Read the full "In Dolore booklet" here.

13 Oct 2012: Giornata Nazionale - National Day against Pain

Giornata Nazionale - raising pain awareness on 56 Italian citysquarestl_files/redakteur-bereich/National Initiatives/Italy/National Day Against Pain/ISAL_National Day against Pain_Flyer_2012.jpg

On October 13th the "Giornata Nazionale contro il dolore" (National Day aigainst Pain) took place on 56 italian citysquares all over the country to raise the awareness of pain. This project was launched by the ISAL Foundation, Grünenthal and Melinda (apple grower). 

During this event every citizen received an apple and had also the opportunity to buy a bag of apple with a contribution of € 5,00. The proceeds of the sale will be assigned to the Research and Training for the treatment of pain thanks to the constant and widespread commitment of ISAL Foundation.

Read more on the website of Fondazione ISAL.

September 2012: Pain Nursing Magazine - Italian Online Journal

Now online!

The first issue of Pain Nursing Magazine – Italian Online Journal is now online! It is a publication for nurses who are fully dedicated to pain patients and their carers (nurses and physicians) through the perspective of answering not only to a health question, but also answering more cultural, social and economic needs.

The aim of the magazine is to achieve the goal of "occupying an intellectual and scientific space of absolute importance and topical interests, wishing to offer a helpful tool of updating news and communication for those who suffer from chronic pain". (..)

 The magazine is quarterly published by the Paolo Procacci Foundation and can be viewed after a simple login on the website.

Go to: Pain Nursing Magazine - Italian Online Journal

13 September 2012: HTA Bari

tl_files/redakteur-bereich/National Initiatives/Italy/E-HTA-Flyer.PNGOn the 13 September 2012 the "HTA del Dolore Episodico Intenso" took place in Bari from 09:15 until 17:00.

Please read the Programma scientifico.

18 June 2012: HTA Firenze

tl_files/redakteur-bereich/National Initiatives/Italy/E-HTA-Flyer.PNGOn the 18 June 2012 the "HTA del Dolore Episodico Intenso" took place in the "Hotel Albani" in Firenze from 09:15 until 17:00.

Please read the Programma scientifico.

13 June 2012: HTA Messina

tl_files/redakteur-bereich/National Initiatives/Italy/E-HTA-Flyer.PNG

On the 13 June 2012 the "HTA del Dolore Episodico Intenso" took place in the "NH Liberty via I Settembre 15" in Messina from 09:15 until 17:00.

Please read the Programma scientifico.

05 June 2012: HTA Ancona

tl_files/redakteur-bereich/National Initiatives/Italy/E-HTA-Flyer.PNGOn the 05 June 2012 the "HTA del Dolore Episodico Intenso" took place in the "Hotel Nh Ancona" in Ancona from 09:15 until 17:00.

Please read the Programma scientifico.

21 May 2012: HTA Padova

tl_files/redakteur-bereich/National Initiatives/Italy/E-HTA-Flyer.PNG

On the 21 May 2012 the "HTA del Dolore Episodico Intenso" took place in the "Hotel Sheraton" in Padova from 09:15 until 17:00.

Please read the Programma scientifico.

17 May 2012: HTA Milan

tl_files/redakteur-bereich/National Initiatives/Italy/E-HTA-Flyer.PNGOn the 17 May 2012 the "HTA del Dolore Episodico Intenso" took place in the "Starhotels Ec.ho" in Milan from 09:15 until 17:00.

Please read the Programma scientifico.

07 May 2012: HTA Rome

tl_files/redakteur-bereich/National Initiatives/Italy/E-HTA-Flyer.PNG

On the 7 May 2012 the "HTA del Dolore Episodico Intenso" took place in the "Centro congressi Europa Università Cattolica del Sacro Cuore" in Rome from 09:00 until 17:30.

Please read attached the Programma scientifico.

20 April 2012: Carta dei Diritti sul dolore inutile

8 Rights for people living with painCarta_Dei_Diritti_Italy

On the 20 April 2012 the Italian health organization "CittadinanzAttiva" (Activecitizenship) established 8 rights to improve the life of people suffering from severe or chronic pain, the "Carta dei diritti sul dolore inutil" (Charter of rights against unnecessary pain).

CittadinanzAttiva is a citizen's organization firmly rooted throughout Italy. It is composed of individuals, groups and networks sharing the wish to establish citizens' role as an active subject in democracy.

The "Carta dei diritti sul dolore inutil" claims that:

-Every individual has the right to know that pain does not necessarily have to be put up with
-Much suffering can be alleviated by adopting the right treatment
-The right not to suffer unnecessarily must be recognised and respected as well in hospital wards as in long term facilities.

Furthermore, this "Charter of rights against unnecessary pain" intends to inform citizens about pain and promote its prevention, control and treatment.

You can take a look at the PDF-Carta dei Diritti sul dolore inutil or read more about it on the CittadinanzAttiva-Homepage

Legge 38

A new law “Policies to guarantee access to palliative care and pain medicine” - impact and perspectives

More information about services and aspects of palliative care of law 38 available on the website of the Italian Ministry of Health.

A short summary on Legge 38 you can find in this PDF.


  • Two integrated networks: palliative and pain medicine
  • Selection of involved professionals
  • Formation and education
  • Funding of informational campaigns
  • Institution of government-level overseeing
  • Explicitly provides for the special needs of pediatric patients

Art. 1

This law grants citizens the legal access rights to palliative care and pain medicine

Art. 2 - Definitions

Palliative Care
Interventions for patients and families in the presence of progressive disease with negative prognosis, not amenable to specific treatment.

Pain Medicine
Diagnostics and therapeutics aimed at suppressing or controlling pain of any etiology.

Person who suffers of chronic pain could evolve in illness and/or pain.

Art. 3 – Responsibilities

National Health Service
Palliative care and pain medicine are priority objectives; implementation is required for access to complementary funding by the government.

Ministry of Health
Defines guidelines for publicity, development and coordination of regional policies.

State-Regions Committee

  • Status of Implementation of the law
  • Appropriateness of interventions
  • Adequacy of available resources with respect to performance

Art. 4

€ 350.000 for information campaigns

Art. 5 State – Regions Committee

  • Institutional Accreditation Criteria
  • Staff Accreditation Criteria
  • System coordination
  • Reimbursement control
  • Care homogeneity

Art. 6 – “Pain-free Hospital & Territory

€ 2.450.000 for staff education

Art. 7 Pain as vital sign: Regular assessment in patients’ medical records.

Pain management is the patient’s right, and the caring physician’s duty.
Law requirements: written records of treatments and outcomes.

Art. 8 Educational Activities

  • Medical school masters and post graduated masters (by the Ministry of Education and Research);
  • CME for physicians and other staff;
  • Compulsory internships/rotations (where applicable);
  • Special education for volunteers and charities/NGOs.

Art 9 and 11 Process Control

National Commission monitors and reports to Parliament about:

  • Network development
  • Performance and Efficiency
  • Education
  • Public information
  • Research
  • Budget
  • Technical reports by experts

Ministry of Health -> National Commission -> Subcommissions 

                                   -> Palliative Care -> National Experts
Subcommissions     -> Pain Medicine -> National Experts
                                   -> Pediatric Care -> National Experts

Art. 10 . Simplification of prescription rules

No more special logs for oral or transdermal opioid formulations. Easier access to analgesics for acute and chronic outpatients. 
Encouraging some of Europe’s most reluctant prescribers

Art. 12

Budget for services: Ministry and State-Regions Permanent Conference:
More or equal € 100 million/year taken from National Health Fund

This law has been so important and well done that it has been taken as a model to make the following declaration of Montreal:

“Access to pain management is a fundamental human right”

Resolution of the Regional Council of the region Marche

Pain relief acute-primary care net (´Ospedale-territorio senya dolore´) - Piloting a new care model

Lucia Di Furia, Luigi Nardi, Alfredo Fogliardi, Fabio Izzicupo, Claudio Caputi, Vincenzo Firetto, Fulvio Borromei, Edoardo Berselli.

The project aims to developing a care model which is able to guarantee, within the hospitals of the Marche Region, both a systematic and uniform detection of pain by the health professional involved (ability to methodically detect pain, ability to understand the level of pain) and consequently,  when necessary, the administration of the appropriate and efficacious analgesic treatment. The health professionals observe and document the level of pain of the patient, as the V vital parameter, using a standardised tool, validated to evaluate the intensity of pain.

In order to do this the project involves a methodological-managed and clinical-care study to be piloted in a so called “Area Vasta”, a well-defined area, which is representative of the critical points and the opportunities of our local healthcare system. Following evaluation of the pilot project, the necessary modifications will be made, before extending the operating system in the entire regional area. The re-organisation and systematization of the current offer of services could guarantee easier access to the current health services, in particular reinforcing the pool of services for adults (and children) in the area.

A new organisational model embedded in the area, will be developed. The level of care will be divided into three complementary sectors: the reference pain treatment centres (HUB), the outpatient analgesic treatment centre (SPOKE), and the GP surgeries.

The project “Ospedale-Territorio senza Dolore” aims at improving the quality of life of patients who need any kind of treatment and who are in pain; the project gets its realisation in controlling pain, which is often associated to other symptoms. It includes the take-off of procedure pain management protocols for adults and children within the hospital.

The need to safeguard both adult and children patients forces the Region to define a project which will identify an organisational pathway able to improve pain relief treatment both in acute and especially in primary care.