Chronic Pain Clinical Trial
Official title:
Cognitive Study on the Use of Central Analgesic Drugs in the Management of Chronic Pain
Chronic pain is defined as pain that persists after healing of the wound that caused it, and
can occur even in the absence of any obvious pathological trigger. In our country, there is
a growing interest in the proper management of the disease "pain".
Pain is also the first symptom of the disease in 20 -50% of patients with neoplastic disease
and from 75% to 90% of patients with advanced cancer suffers from chronic pain .
However, pain management is mostly inadequate. This study aims to assess the Italian
clinical practice in reference to the pharmacological management of chronic pain by health
professionals involved in the treatment of pain in some centers belonging to the Italian
network of pain therapy.
Chronic pain is defined as pain that persists after healing of the wound that caused it, and
can occur even in the absence of any obvious pathological trigger. In our country, there is
a growing interest in the proper management of the disease "pain".
In fact, the Ministry of Health, first in Europe, introduced a law in 2010 (March 15, 2010,
No. 38) to provide for the sick, cancer or not, easy access to the necessary care and to
provide specialists a specific training course.
Pain is also the first symptom of the disease in 20 -50% of patients with neoplastic disease
and from 75% to 90% of patients with advanced cancer suffers from chronic pain (Marcus
2011).
The "pain disease" is one of the most common causes of access to medical care so it should
be recognized as a complex health and research problem, being one of the most expensive and
investigated conditions in our society (Pizzo and Clark, 2012; Gupta et al. , 2010; Dagenais
et al., 2008).
It has a significant impact on the subjective perception of health status, influence daily
activities and is associated with symptoms of depression and other psychological problems
that affect the quality of life of the patient (end of 2011 Gureje et al., 1998; Bair et
al., 2003, Portenoy, 1996).
However, pain management is mostly inadequate for several medical and social reasons:
difficulty in defining the complexity of its pathophysiology, difficulty in finding animal
models useful for the development of analgesic drugs, difficulty in finding clinical models
predictive of drug efficacy / security, lack of recognition of pain as a health issue and
not adequate academic training.
A recent survey in Europe uncovered alarming data: 40% of surveyed patients (46,394)
reported an inadequate treatment of accused pain (Breivik et al., 2006).
There are also several open questions regarding the research on the most powerful analgesic
drugs used: opioids (Galer et al 1992).
There is no specific experimental model able to solve the three most pressing problems: the
predictability of the patient's response, efficacy and safety of opioids.
There is no scientific evidence for the efficacy / safety of long-term use of opioids in
chronic pain (Chapman et al., 2010; Manchikanti et al., 2011).
A recent review showed that approximately 22% of patients, suffering from chronic pain and
on opioid therapy, suspends therapy for the occurrence of side effects and 5-10% of patients
suspend it for a not proper control of pain symptoms (Noble et al., 2010).
This study aims to assess the Italian clinical practice in reference to the pharmacological
management of chronic pain by health professionals involved in the treatment of pain in some
centers belonging to the Italian network of pain therapy.
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Observational Model: Cohort, Time Perspective: Prospective
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