Pain is a symptom that is present in many acute and chronic diseases and clinical situations. It is one of the most disabling components for patients suffering from it, not only because of its physical and mental impact but also because, in many cases, it can limit the optimal therapeutic approach of other pathologies.
An adequate treatment can only be achieved with a multidisciplinary approach. Multiple pathologies (musculoskeletal, neurological, psychiatric, visceral...) are able to predispose the development of chronic pain. Knowledge and involvement of the different medical specialties (Neurology, Neurosurgery, Psychiatry, Rheumatology, Rehabilitation, Geriatrics, Orthopedic Surgery, Gynecology, and Orofacial Surgery..., in addition to Anesthesiology) is necessary to be able to treat it properly.
The alteration of the nociceptive mechanisms and their interaction on emotional and behavioral processes, especially in patients with chronic pain, also require a thorough examination of the psychosocial factors that affect patients and their environment, so disciplines such as Psychology, Physiotherapy, Nursing Occupational Therapy, Nutrition, and others, are necessary in the therapeutic approach.
The high prevalence of chronic pain (approximately 23 % of the population), the need for early diagnosis and basic support in the patient’s life, requires that Family Medicine (with specialized training), the closest specialty to the patient in our Health System, be essential in the care of these patients. Finally, specialties such as Biology, Physiology, Genetics, Neurosciences, Pharmacology, Pharmacy, Bioengineering and others are basic in research applied to pain knowledge and its treatment.
Over the past 25 years, significant efforts have been made in the development of Pain Clinics (yet, in our country, there are just over a hundred) mostly integrated into Anesthesiology Departments. Anesthesiologists lead units, but always bearing in mind that the-e approach of a pathology as complex as pain must be multidisciplinary and multimodal, with adequate coordination of all the professionals involved.
The goal is to establish a multidimensional space, integrating specialties and professionals involved in the diagnosis, treatment and follow-up of the patient with pain and to ensure that as many professionals as possible have the necessary knowledge, both theoretical and practical, about pain. To achieve this goal, it is imperative to promote Pain Treatment Accreditation in line with the Core Curriculum for Professional Education in Pain, as recommended by the International Association for Study of Pain (IASP) (1).
In this context we, a large and multidisciplinary international group of professionals, have agreed on the need to create a new scientific society, SEMDOR (Spanish Multidisciplinary Pain Society) that will enable a qualitative and innovative leap in the best way to address the processes of training and transmission of knowledge, from the multidisciplinary integration of the different specialties.
In this spirit, one of SEMDOR’s main goals is to develop Accreditation Areas integrated in the National Health System until the creation of a University Educational Campus on Pain and the launch of a scientific journal that will be a vehicle for knowledge in pain. All these objectives will be implemented with participation, in fair balance, of all existing specialties.
We would like to thank all SEMDOR members for their commitment. Among all of us we to lead an updated renewal in the approach to pain management, making a great international scientific society to achieve our goals.
1. For Accreditation, we propose and will request the creation, for specialists of a Two-Years Pain Training and Accreditation Program (Postgraduate-MIR) that incorporates the capabilities included in the recognized competencies of all the specialties involved, following our core idea that SEMDOR is a true multidisciplinary society, where no one who treats patients with pain be left out of specialized training or institutional support. Only in this way can we guarantee a qualified and safe dedication.
It is necessary and urgent to increase the number of specific Pain Clinics of both chronic and acute pain in public and private hospitals. In order to achieve this goal, it is mandatory to increase the number of professionals who are trained and accredited in Pain Treatment by the appropriate professional accreditation authorities.
It is necessary to promote knowledge of pain in Primary Care Centers, where there may be qualified reference doctors in pain, with an excellent level of communication and coordination with the Pain Clinics, stimulating a coordinated growth. We need to request an increase in pain training funding from national and regional health authorities. Only then can the number of Pain Units be increased. No hospital without a Pain Unit. These must be multidisciplinary, accredited, with autonomy of management and they must provide assistance stability over time, training and research. These units will be supported and accredited by SEMDOR.
2. Training is required to achieve Accreditation. From SEMDOR we will focus on accredited training. With the official creation of a University Educational Campus in Pain, which helps to train professionals involved in pain treatment (doctors, psychologists, pharmacists, dentists, physical therapists, nurses...) including residents and prioritizing those who have less training capacity in their regions. The goal is to launch an official accreditation and degree programs for Units and Members.
3. The generation and transformation of knowledge is the main core of our initiative. Our vehicle of training and scientific communication will be our scientific meetings, our website (www.semdor.es) and the scientific journal “Multidisciplinary Pain Journal”. All relevant scientific information will be published in our journal with the aim of having international presence and be present in the bibliographic indices as soon as possible. It is born with the aim of having a serious, rigorous and scientific space but, at the same time, open a multidisciplinary hub to collect and spread all the knowledge about pain. We want it to be an international reference scientific Journal that is open to the publication of any kind of pain-related scientific knowledge, and allow the access to all kinds of papers related to pain and at the same time, the authors will be able to disseminate in a fast and modern way all their knowledge in this area.
4. SEMDOR has a strong anchor in Spanish-speaking countries, so we will strengthen relations with all institutions to make a common front for our objectives, integrating into all international pain agencies and societies. It is only possible to achieve this goal, with intense work of professionals on social networks and with good communication. We will also promote information to patients with pain by all possible means, work with patient associations (with which we will have a very close relationship) to improve patient-professional communication, and intensify relationships with the pharmaceutical and healthcare industry, from independence, by establishing collaborative educational programs. Our goal is to create the position of the “Advocate against Pain”, who would be in charge of all professional issues and communication with the Regional Communities and the Ministries of Health and Education as well as professionalizing media relations with the creation of a Press Office and educational and formative activities to promote knowledge about pain.
SEMDOR was born to gather all those health professionals interested in improving the quality of life of those who suffer pain, and to bring back those colleagues that, disappointed, walked away in recent years. We have made the fight against pain the professional goal of our lives and we will remain committed to a society of all members and for all members, regaining the foundational spirit with which
Dr. Bonica created the IASP.
From SEMDOR we will be fully dedicate to improve the quality of life of the pain patients and to the care and promotion of its members and partners, providing values, initiatives, training, ideas, activities and depth in all areas related to it. Knowledge, professionalism and values will benefit patients suffering from pain. We will achieve the future with the effort, contribution of all of us, our talent is our strength, and our commitment is a world with less pain.
We all together will be able to move forward against pain.
REFERENCES
1. Charlton JE (ed.). Core Curriculum for professional education in pain [Internet]. IASP Press; 2018. Disponible en: http://issuu.com/iasp/docs/core-corecurriculum