Experts in Poland call for enhanced care in chronic pain conditions

Poland’s strategies for managing chronic pain seem to be insufficient and the use of strong opioid analgesics for acute and chronic pain is significantly below the European average, health experts have noted, emphasising that more action is needed.

Data shows that approximately 20% of Poland’s population is affected by chronic pain, and more than 5% experience severe pain.

Individuals enduring chronic pain, persisting for more than three months, face a considerably elevated risk of developing depression, anxiety, cognitive disorders, and sleep disturbances.

Chronic pain not only imposes a personal burden but also exerts a substantial economic toll on the healthcare system, employers, and society at large. Therefore, experts emphasise the importance of systematic pain intensity measurement and outcomes evaluation for effective pain relief.

Pharmacotherapy remains the primary approach to pain management, and Polish law has granted every patient the right to pain treatment since May 2017.

However, data indicates that Poland lags behind many European countries in effectively managing chronic pain.

In response, on 17 October the Polish Society for the Study of Pain presented recommendations aimed at enhancing the quality of chronic pain treatment in the country during a press conference in Warsaw as part of The Global Day against Pain.

The data shows that Poland ranks fifth in Europe in non-prescription painkiller sales, behind the United Kingdom and Germany but ahead of the Netherlands, Italy, and Ukraine.

Interestingly, the use of potent opioid drugs, highly effective for treating acute pain (post-operative or post-traumatic) and chronic pain in cancer patients, is, on average, five times lower than the European average.

“In the consumption of opioids, and also in the quality of pain medicine, we are still at the level of Montenegro, Russia, Albania,” the president of the Polish Society for the Study of Pain (PTBB), Dr Magdalena Kocot-Kępska, told the conference in Warsaw.

Dr Jarosław Woroń, secretary of the Polish Society for the Study of Pain, told Euractiv that “patients and their families are often afraid of opioids; physicians are often afraid to prescribe them as well”.

The fear of opioid use often arises from the fear of potential addiction.

“Of course, there is a genuine risk of addiction if opioids are used inappropriately, with incorrect dosages, for extended periods, or in combination with certain medications,” Woroń explained to Euractiv.

“Nevertheless, when opioids are correctly prescribed and administered, they can be a safe and effective approach for managing severe pain, provided the appropriate dosage, duration, and concurrent therapies are employed to mitigate the risk of excessive opioid usage.”

Woroń highlighted that chronic pain affects more than eight million individuals in Poland and noted that practically every other patient aged 65 and above experiences pain-related discomfort. If these ailments remain untreated properly, they can evolve into a chronic condition.

Recognising the issue is just the first step and strategies for improvement must follow.

Therefore, the Polish Society for the Study of Pain, in cooperation with the Experts for Health Foundation, has developed recommendations for the implementation of chronic pain prevention and treatment, including the use of integrated pain medicine.

A key recommendation aims to increase the valuation of health services provided in pain management clinics, as the current valuation is deemed inadequate.

Additional recommendations include establishing specialised multidisciplinary pain centres to deliver comprehensive care, including pharmacotherapy, alternative therapies, lifestyle modifications, and psychotherapy.

According to Dr Kocot-Kępska, those departments must be run by pain medicine specialists, that is, people who have experience in pain medicine, have European specialisations, or are post-graduates in this field.

“At the moment, this is the only guarantee of adequate knowledge in pain treatment,” she said.

Another significant proposal is the creation of a treatment pathway for patients suffering from post-herpetic neuralgia, a painful complication of shingles that often lasts a lifetime.

Finally, the Polish Society for Pain Research plans to advocate for chronic pain to be officially recognised as a chronic disease, enabling more specialised medical practitioners to offer pain management services, which the national health fund would cover.

However, improving the quality of the pain management system comes with costs and it remains to be seen if the new government will allocate the required funding for these initiatives.

[Paulina Mozolewska – Edited by Vasiliki Angouridi/Zoran Radosavljevic | Euractiv.com]

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