Care systems and access, quality and economics

Introduction In Italy, organizations of chronic patients have called attention to the obstacles in obtaining pain therapy at pain clinics, where GP plays a key role in starting the therapeutic process for obtaining relief from pain. Furthermore, the first physician consulted by the patient may take time in informing the said patient about the possibility of contacting a specialized centre, involving, at times, delays of a few months. The aim of this study is to investigate the provenance of patients from three pain clinics. Methods Since our first visit in 2011, 168 outpatient pain clinics records have been studied, in Italy. We have investigated the provenance of these patients, indicating who referred the patient to the centre, that is to say GP, a specialist or a patient’s relatives or friends. Results 19.8% of cases were referred to the pain clinics by their GP, 45% by the specialist, and 38% on the patient’s initiative or following the advice of friends. 72.7% of the latter group are patients who attended a regional health centre.It becomes clear that the role of a GP or nurse in referring patients for pain therapy is not instrumental. This could be attributed to the high labour costs involved or to a lack of awareness about the services offer. When a referral is made by a specialist, there can be delays in treating pain. The role of a nurse, still unexploited in these centres, could assist a GP, and collaborate with patients associations to diffuse information about the therapeutic options available to treat pain in centres devoted to this end.