The current status of pain clinics in Italy: a questionnaire survey

One hundred-eight questionnaires were mailed to Pain and Headache Centers evenly spread throughout Italy to evaluate the current status of pain clinics and therapy. Sixty-three centers (58.3%) responded: fifty-two (82.5%) were Pain Clinics, while eleven (17.5%) were Headache Clinics. Approximately half of the clinics were run by anesthesiologists (43.3%), followed by neurosurgeons (15%), and neurologists (10%). The Pain Team involved up to 26 members (average number: 7), with representatives from anesthesiologists (71.4%), psychologists and psychiatrists (52.4%), neurologists (36.5%), specialists in internal medicine (23.8%), and neurosurgeons (20.6%). The outpatient pain clinic made up the great majority of the respondents (80.9%), whereas the in-patient service for both emergency and elective pain treatment was available in twenty-six centers (41.3%). A total of 49.445 patients (average number: 810) were treated in a period of one year. Pain syndromes most frequently treated (mean incidence) were (a) cancer pain (39.0%); (b) chronic primary headache (37.3%); (c) non-oncologic extra-cephalic pain (37.0%); and (d) orofacial pain (17.2%). A multidisciplinary team approach was used by 65% of the respondents. Treatment modalities most frequently used were drugs (mean utilization index, MUI: 138), followed by anesthesiological methods (MUI: 70), neuroaugmentive procedures (MUI: 51), psychiatric and psychophysiological methods (MUI: 33), and neurosurgical procedures (MUI: 28). Mean percent immediate and long-term treatment successes (pain relief 50%) were the following: (a) cancer pain (74.7-63.3%): (b) non-oncologic pain (66.7-50.3%); (c) chronic primary headache (64.2-52.6%); and (d) orofacial pain (64.2-52.5%).(ABSTRACT TRUNCATED AT 250 WORDS)