26° WONCA Europe Conference
Abstract dal Book Congressuale
The reason why pain training is important
for the General Practitioner
Iannantuoni L., Placentino N.P., D’Errico G.B
The specific skills needed to deal with a frequent problem such as pain are not particularly well-established and we can come across practices that are not always correct and, at times, influenced by real taboos.
This may result in inappropriate management of the “patient with pain”, be it cancer or non-cancer, acute or chronic, situation swhich, in order to be successfully addressed, require competence, management skills, integration of their competences and / or roles with
those of other operators and … empathy.
The role of the General Practitioner in pain therapy and palliative care is of particular importance as the first interlocutor of the patient, therefore it is important that he has specific skills and knowledge.
Law 38/2010: access to palliative care and pain therapy
Through this law, access to palliative care and pain therapy is protected and guaranteed for the patient with an incurable disease or suffering from a chronic painful disease, with the aim of ensuring respect for the dignity and autonomy of the human person, the need for health, equity in access to care throughout the country, the quality of care and their appropriateness with regard to
to specific needs.
The most important and innovative aspects of the law are:
a) The detection of pain within the medical record;
b) The promotion and integration of national networks for palliative care and pain therapy;
c) The simplification of procedures for accessing medicines used in pain therapy;
d) The training of medical and health personnel in the specific field of analgesic therapies.
Role and Tasks of General Practitioner
1) Detect pain during the outpatient and / or home visit;
2) Periodically reassess the intensity of pain;
3) Treat any side effects of drug therapy;
4) Instruct family members to manage the “critical” phases;
5) Evaluate when the analgesic treatment becomes a specialist competence;
6) Collaborate with the specialist of the analgesic therapy center in the management of complex patients (for example: Invasive analgesic therapy, etc …);
7) Promote the education of patients and family members in the correct detection of pain and the correct administration of drugs.
Beyond the good intentions, law 38/2010 still finds a partial and uneven application throughout the national territory. The establishment specific training courses in palliative care and pain therapy related to neoplastic and / or chronic degenerative diseases,
both in the university study plan and in post-graduate training is still to come, except for the masters, moreover established patchy.
It is hoped, considering it essential for the training of the Doctor, not only the introduction of “pain medicine” in university curricula, but also the activation of real specialization courses and the introduction of training and in-depth courses of the subject in Specific Training Courses in General Medicine.