Background & Aims
Approximately one third of the population lives with some type of chronic pain (CP) in Portugal. CP is an independent condition, having a biopsychosocial impact on the patient that affects individual, familiar, social, professional and recreational life.
In addition, CP represents a great economic burden. In Portugal, there is an estimated average of annual cost of 4,611.69 million euros, with 42.7% direct costs and 57.3% indirect costs, which corresponded to 2.71% of portuguese annual GDP in 2010.
Providing care in this area has become a major challenge for health systems, particularly in Portugal, where there is poor pain control and the profile of healthcare use is influenced by clinical needs, healthcare access inequalities , variability in the approach to these patients, gender, education, lifestyle habits and multimorbidity. This confirms Andersen’s Behavioral Model, once the influence of contextual factors is added to that of individual factors.
Methods
The data search was conducted taking into account the evidence published in scientific journals regarding the status quo of healthcare and personalized care in chronic non-cancer pain management in Portugal.
Authors also considered programs, strategies and guidelines defined by the responsible entities (namely, the General Directorate of Health), as well as existing legislation, the organization of chronic non-cancer pain care in the national healthcare service and the training opportunities for doctors to promote the management of chronic non-cancer pain.
Results
The high prevalence of CP in Portugal, justifies the need to develop research in this area – already carried out in several academic centers across the country.
General health directorate developed the regulatory principles for the national pain control plan and issued standards and guidelines for pain management.
Legislation focuses on healthcare organization in the management of pain, namely access to medicines and organization of services (mainly hospitalary).
Investment in local care, particularly in primary care, where chronic non-cancer pain is one of the main registered reasons for consultation is essential
Recent organization of local health units in the provision of healthcare in Portugal may be an opportunity to optimize the approach to to these patients.
Conclusions
Much has been done, but much more remains to be done in the management of chronic non-cancer pain in Portugal, training health professionals and organizing healthcare solutions.
References
1. Azevedo LF, Costa-Pereira A, Mendonça L, Dias CC, Castro-Lopes JM. Epidemiology of chronic pain: A population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. J Pain. 2012 Aug;13(8):773–83.
2. Antunes F, Pereira RM, Afonso V, Tinoco R. Prevalence and Characteristics of Chronic Pain Among Patients in Portuguese Primary Care Units. Pain Ther [Internet]. 2021;10(2):1427–37. Available from: https://doi.org/10.1007/s40122-021-00308-2
3. Treede, Rolf-Detlefa,*; Rief, Winfriedb; Barke, Antoniab; Aziz, Qasimc; Bennett, Michael I.d; Benoliel, Rafaele; Cohen, Miltonf; Evers, Stefang; Finnerup, Nanna B.h, i; First, Michael B.j; Giamberardino, Maria Adelek; Kaasa, Steinl, m, n; Korwisi, Beatric C. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11) [Internet]. Pain. 2019. p. 19–27. Available from: https://journals.lww.com/pain/abstract/2019/01000/chronic_pain_as_a_symptom_or_a_disease__the_iasp.3.aspx
4. Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth [Internet]. 2019;123(2):e273–83. Available from: https://doi.org/10.1016/j.bja.2019.03.023
5. Mills S, Torrance N, Smith BH. Identification and Management of Chronic Pain in Primary Care: a Review. Curr Psychiatry Rep. 2016;18(2):1–9.
6. Azevedo LF, Costa-Pereira A, Mendonça L, Dias CC, Castro-Lopes JM. The economic impact of chronic pain: a nationwide population-based cost-of-illness study in Portugal. Eur J Heal Econ. 2016;17(1):87–98.
11. Østeras N, Jordan KP, Clausen B, Cordeiro C, Dziedzic K, Edwards J, et al. Self-reported quality care for knee osteoarthritis: Comparisons across Denmark, Norway, Portugal and the UK. RMD Open. 2015;1(1):1–9.
12. Costa D, Cruz EB, Lopes DG, da Silva CN, Henriques AR, Luis D, et al. Prevalence of and factors associated with unmanageable pain levels in people with knee or hip osteoarthritis: a cross-sectional population-based study. BMC Musculoskelet Disord [Internet]. 2023;24(1):1–13. Available from: https://doi.org/10.1186/s12891-022-06110-1
13. Costa D, Rodrigues AM, Cruz EB, Canhão H, Branco J, Nunes C. Driving factors for the utilisation of healthcare services by people with osteoarthritis in Portugal: results from a nationwide population-based study. BMC Health Serv Res. 2021;21(1):1–13.
Presenting Author
Catarina Matias
Poster Authors
Catarina Matias
MD
Faculty of Medicine of Coimbra University; ULS de Coimbra
Lead Author
Topics
- Access to Care