In this section, national initiatives which have been set up in Spain can be found.
Strategies for the improvement of pain care in Andalusia
In Andalusia, in response to national laws and the actual Andalusian autonomic law, which includes the right of patients to receive adequate pain treatment and within the Andalusian Quality Plan, integrated care processes (ICP) were developed, like Non- Cancer Chronic Pain ICP, Fibromyalgia ICP and Palliative Care ICP, all of them published in 2005.
These processes are directly related to addressing pain, and in late 2007 a working group was formed to develop a comprehensive strategic plan aimed at pain prevention, care and rehabilitation of patients with pain, which was published in May 2010 with the title "Andalusian Caring Plan for People in Pain" (ACPPP).
The ACPPP was developed by a multidisciplinary group composed of 24 professionals (anesthesiologists, surgeons, nurses, sport experts, pharmacists, A&E physicians, pediatricians, psychologists, psychiatrists, rehabilitation physicians, interventional radiologists, orthopedic surgeons, epidemiologists, technical and administrative personnel led by Reyes Sanz, phD,MD and Juan Antonio Guerra phD,MD.
Once established, the group proceeded to define the scope of the plan and to analyse the situation from a quantitative and qualitative perspective. The state of the existing care situation and needs in our community were established, the objectives were formulated and improvement and implementation actions were designed in relation to training, resources, evaluation and communication; these actions are grouped into 6 major lines consistent with the strategic objectives.
The draft was subsequently sent to external review to both scientific societies and professional experts, the necessary changes were incorporated and the final ACPPP document was published.
The ACPPP was launched in June 2010 and until 2011 it has developed the foundations for the subsequent implementation of other elements, the most important ones developed to date are:
- The review and update of ICPs: non-cancer chronic pain, fibromyalgia, Palliative Care, and ICP “surgical block” (deals with care to postoperative pain from any mayor surgery procedure) and the development of an evidence based clinical practice guideline about the safe use of opioids for terminal care.
- The training program, which covers general training on chronic pain and specific training on psycho-education, exercise prescription and physical activity and the safe use of opioid prescriptions.
- The development of general competencies for all health service professionals, shared skills for groups of professionals in areas related to the scope of the plan and specific skills in relation to the ICPs developed.
- The development of a sign of quality called: "Centres Against Pain " aimed at GP Centers, hospitals and pain management units.
- The development of a safety program for the Pain Management Units of hospitals.
The next challenges that will be addressed during the remaining term of the plan (2010-2013), are to incorporate intermediate and final indicators of health outcomes to the digital history to assess changes in healthcare and citizens health, to incorporate aspects of attention to pain in the portfolio of health facilities and improvement goals for these centres, to continue with the training activities and the final evaluation of the ACPPP itself.
SIP Spain was successfully launched on June 26th 2018 in Spain after several patient organisations and clinical experts came together with representatives from the Ministry of Health and three other regional communities.
Juan Perez Cajaraville
Maria Soledad Garcia Penalta