Health Policy - Invest in training

Pain therapy and end-of-life care are rising in importance on the European agenda.

Stakeholders are requesting the EU to set up European networks for palliative care and pain therapy. The focus should definitely be on the training of specialists and exchange of best practices.

Better education on pain management and the need to promote the exchange on best practices in Europe were called for in November as part of the 5th symposium on the Societal Impact of Pain, SIP. SIP is an international multi-stakeholder platform with the aim of raising awareness of the relevance of the impact of pain on our society, health and economic systems.

Pain therapy and palliative care were listed as priorities by the Italian Presidency of the EU and, for the first time ever, all EU ministers of health discussed this topic at the recent informal meeting of the health ministers in September. Delegates of the SIP symposium, supported by the Italian Presidency, welcomed the EU health ministers’ decision to create a European network for training healthcare professionals and exchanging information.

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 member states should be able to benefit from already existing best practices to avoid inequalities in access to pain therapy. Furthermore the EU Commission and member states should secure the necessary resources to ensure that a European network is put in place for the benefit of European patients. This applies particularly to the needs of the elderly and very young paediatric patients.

Access to pain therapies
Marco Spizzichino, Director of Office XI, Palliative Care and Pain Therapy in the Italian Ministry of Health, General Directorate for Health Planning, referred on behalf of the Italian Minister of Health Beatrice Lorenzin to law 38/2010, which ensures access to pain therapies in Italy: “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.”
Spizzichino also emphasised the need to ensure access to all currently available treatments and to reduce the inequalities in access to treatment between regions and the European member states: “Upholding the right of the patients to avoid unnecessary suffering and pain should be a national and European priority.”

Willem Scholten, a former employee of the World Health Organisation WHO, reiterated the Italian Minster of Health's request and emphasised that “Opioid analgesics are considered to be essential medicines by the WHO and are necessary for the treatment of moderate to severe pain. However, there are no uniform guidelines allowing access to these medicines.”

The SIP participants recognised the need for EU member states to equally apply the 2011 WHO guidelines for controlled substances. The exchange of best practices could also contribute to improving the management of controlled substances and reducing the social consequences of misuse.

Approximately 100 million European citizens, and 50% of the older population in Europe, suffer from chronic pain. Overall chronic pain causes 500 million days of illness in Europe and costs the European economy more than €34 billion. Dr Chris Wells, President of the European Pain Federation EFIC® pointed out that “Early treatment of pain, particularly back pain, can achieve huge cost savings and a reduction in sick leave and inability to work.”

Improve training
Depression, anxiety disorders, reduced physical mobility and social isolation are frequently associated with chronic pain. Depression and back pain are two of the five main reasons that result in inability to work in all European countries. And yet, 82 percent of the universities provide no courses on pain therapy for undergraduate medical students in Europe – at any rate, there are no courses that are compulsory for all students.
The effects on European society are considerable as chronic pain is one of the major reasons why people exit the labour market prematurely.
“Therefore, we have to invest in training young professionals when it comes to pain and palliative care. The topic must be given more attention in the curricula of medical education in Europe and the world”, Professor Hans-Georg Kress, the former President of the EFIC® concluded.
The European Pain Society EFIC® (European Federation of IASP Chapters®) is responsible for the scientific contents of the SIP platform.

A German version of the article is available at:

SIP, Ärzte Woche 50/2014
© 2014 Springer-Verlag GmbH, Impressum

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