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ORGANISATION OF SERVICE FOR THE TREATMENT OF CHRONIC PAIN IN THE REPUBLIC OF CROATIA

ORGANISATION OF SERVICE FOR THE TREATMENT OF CHRONIC PAIN IN THE REPUBLIC OF CROATIA. Vesna Golubović, MD PhD Department of Anaesthesiology, Reanimathology and Intensive Therapy Medical Faculty Rijeka University of Rijeka. The anaesthesiologists started with the pain management at the :

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ORGANISATION OF SERVICE FOR THE TREATMENT OF CHRONIC PAIN IN THE REPUBLIC OF CROATIA

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  1. ORGANISATION OF SERVICE FOR THE TREATMENT OF CHRONIC PAIN IN THE REPUBLIC OF CROATIA Vesna Golubović, MD PhD Department of Anaesthesiology, Reanimathology and Intensive Therapy Medical Faculty Rijeka University of Rijeka

  2. The anaesthesiologists started with thepainmanagement at the : Department of Neurosurgery in Clinical Hospital Centre Zagreb in 1978. The Clinic for Pain Management in General Hospital in Karlovac in 1979., The Clinic for Pain Management The ClinicalHospital Centre in Rijeka in 1986. The Clinic for Pain Management The General Hospital in Osijek in 1989.

  3. In 1994 the Croatian Society for Anaesthesiology, Reanimation and Intensive Care (HDAIL) within the Croatian Medical Association (CMA) starts with the organisation of the centres for the treatment of pain, but the activity ends with the change of presidency.

  4. In 1994. the Croatian Society for Hospicium/Palliative Care (HDH/PS) was founded at CMA (at that time the President was Prof. dr. sc. Anica Jušić). Anaesthesiologists were included in the activity of this society from the very first day (Dr. Marijana Persoli-Gudelj was the vice-president of the Society).

  5. On 31st March 2000 the Croatian Society for the Treatment of Pain (HDAIL) within the Croatian Medical Association - CMA was founded in Zagreb. The founders and actuators of the Society were the Clinic for the pain management from General Hospital Karlovac, the Croatian Society for Hospitium/Palliative care (HDH/PS) at CMA and the Department for Anaesthesiology of Medical Faculty Zagreb. The first President of the Society was Prim. Dr. Marijana Persoli-Gudelj.

  6. OSNIVAČKA SKUPŠTINA HRVATSKOG DRUŠTVAZA LIJEČENJE BOLIPetak, 31.ožujka 2000. HLZ-Šubićeva 9, Zagreb Radno predsjedništvo: Prim dr Marijana Persoli- Gudelj Prof dr Višnja Majerić- Kogler Prof dr Anica Jušić

  7. Prim dr Marijana Persoli- Gudelj • Prim dr Egidio Čepulić • Prof dr Božidar Vrhovac • Prof dr Nikša Zurag • Doc dr Vesna Golubović • dr sci Josip Žunić • Doc dr Mladen Havelka • Prof dr Višnja Majerić Kogler • Doc dr Antun Bačić • Prof dr Anica Jušić • dr Maja Grba-Bujević • Prim dr Biserka Valjak • dr Ines Adanić Mikloška • dr Mira Fingler • dr mr sci Tonko Vlak • dr mr sci Biserka Štambuk • dr mr sci Zlatko Houra INICIJATIVNI ODBOR ZA OSNIVANJE DRUŠTVA ZA LIJEČENJE BOLI-HLZ

  8. It was proclaimed in 1989. in the USA that the pain treatment is the fourth field of the anaesthesiologists practice, besides anaesthesia, intensive therapy and reanimatology. • The treatment of pain (algology) is today growing into a new clinical discipline in most developing countries of the world and our association is promoting the guidelines according to EFIC.

  9. The Croatian Society for PainManagement become the member of the European Federation of IASP Chapters (EFIC), and International Association for the Study of Pain (IASP) in 2002.

  10. Since 2002. the Croatian Society for the Pain Management (HDAIL) has been included in the global project Europe against Pain (EAP) in which take part World Health Organisation (WHO), European Federation of IASP Chapters (EFIC), and International Association for the Study of Pain (IASP).

  11. Each year during 1 week in October in many Croatian cities medical educational personal and volunteers organize lectures about pain and treatement inducing media attention (TV, radio, newspapers, etc.) and animating community to be aware that pain is a desease that can be treated.

  12. In our country each year since 1997. in Karlovac has been organized one day symposium dedicated to the treatment of pain and has been held in co-operation with many world known experts in this field . The topics of the symposium included the following issues: Treatment of malignant pain - modern approach; Three step analgesic scale - WHO; Analgesics-opiates/neo-opiates; Ethics Palliative medicine; Pain in elderly people; Pain in children; Pain in women; Neuropathic pain.

  13. Since 27th November 2003. by the decision of the Croatian Insurance Health Organisation (HZZO) the Clinics for the pain treatment have become specially registered (coded) sub-services within the frame of anaesthesiology.

  14. Pain treatment as entirely new medical branch lay on particular education. Curriculum for subspecialisation in pain medicine in Croatia was made 4 years ago, and still it has not been approved by Ministry of Health and Social Welfer.

  15. “Pain medicine as a speciality, a sub-speciality or supraspeciality, has been realised in some countries as Turkey, Finland and Sweden. This is a very important political topic that EFIC need to have focus on, and helping other national societies in their efforts to establish pain medicine as a recognised sub-speciality” (Harald Brevik, President of EFIC, President's Message in EFIC Newsletter, January 16th, 2003.).

  16. Since 2000. postgraduate courses of first category have been held and organized by the Department of Anaesthesiology of Medical Faculty University of Zagreb and Osijek. Until nowadays the topics were: Chronic pain – diagnosis and treatment – general part; Chronic pain – diagnosis and treatment – special part; Pain in children – diagnosis and treatment; Pain treatment in cancer patients; Acute pain - diagnosis and treatment; Neuropatic pain- diagnosis and treatment.

  17. The 1st Congress of the Croatian Society for Pain Management with international participation was held at the Lakes of Plitvice from 12 – 14th October 2006. The goal of that Congress was to promote multidisciplinary approach for the treatment of acute and chronic pain and to inform and discuss with the audience on the contemporary model for the treatment of pain in Croatia.

  18. Members of the Croatian Society for Pain Management regularly participate in numerous other symposiums and congresses (oncology, physiatrics, neurology, surgery, or maxillofacial surgery, plastic and reconstructive surgery, primary care medicine etc.) promoting multidisciplinary approach in pain treatement.

  19. The Society has been very active in education of population (gerontology public lectures, symposium for 100% war invalids, symposium for paraplegic patients, education for employees in the old people homes, public lectures etc.).

  20. The members of the Croatian Society for Pain Management have issued many papers: books, scripts,supplements, brochures, declarations, translationsof IASP and EFIC materials etc.

  21. The Society for Pain Management advocated and supported registration of many drugs in our country (Kapanol, Durogestic , MST Continus, Sevredol, Transtec , Fentanyl M, Oxycontin, Zaldiar, Palladon,Versatis,etc).

  22. The data of the Croatian Insurance Health Organisation (HZZO) for 2008. are following: Centre for Pain Management - Clinical Hospital Zagreb, Department for Pain Management and Palliative Medicine - General Hospital Karlovac, Department for Pain Management and Hyperbaric Medicine - Clinical Hospital Osijek, 25 Pain Management Clinics – as a part of Departments of anaesthesiology

  23. The EFIC - Grunenthal scholarship (EEG scholarship) for 2008. won the member of the Society Dr.sc. Marijana Braš from Clinical Hospital Centre in Zagreb on topic: Connection of COMT polymorphism with chronic lumbar pain syndrome of PTSP linked with war.

  24. The members of the Society took active part as invited lecturers, oral or poster presenters and participants in numerous domestic andinternational congresses and seminars .

  25. COMPARATION OF POSTOPERATIVE PAIN MANAGEMENT TECHIQUES OF EXPRESSION OF CYTOLITIC MOLECULE PERFORIN V. Golubovic,S. Golubovic, V. Sotosek Tokmadzic, M. Petkovic , I. Mrakovcic-Sutic, EPIDURAL ANALGESIA-INDUCED IMMUNOMODULATION OF CELL-MADIATED CITOTOXICITY IN PATIENTS WITH COLORECTAL CARCINOMA S. Golubovic,V. Golubovic,V. Sotosek Tokmadzic, M. Petkovic, I. Mrakovcic-Sutic Department of Anesthesiology, Reanimatology and Intensive Care, Medical Faculty, University of Rijeka, Croatia, Department of Physiology and Immunology, Medical Faculty, University of Rijeka, Croatia

  26. THE INFLUENCE OF EARLY CONTINOUS EPIDURAL ANALGESIA ON HEMODYINAMIC CHANGES IN ELDERLY TRAUMA PATIENTS WITH SEVERAL PELVIC FRACTURES D. Bartolek, K. Sakić-Zdravčević, A. Jokić Anaesthesiology nad ICU, University Clinic of Traumatology, Zagreb, Croatia, Anesthesiology, Clinic Hospital Center Zagreb, Zagreb, Croatia, Anesthesiology, General Hospital “Sveti Duh”, Zagreb, Croatia CONTINIOUS WOUND INFUSION OF LEVOBUPIVACINE PROVIDES EFFECTIVE ANALGESIA AFTER COLORECTAL SURGERY S. Marić, L. Stefancic, D. Krleža Šupić, D. Vrdoljak, K. Zdravcevic Sakic Anesthesiology and Intensive Care, University Hospital for Tumors, Zagreb Croatia, Anesthesiology and Intensive Care, University Hospital Center Zagreb, Zagreb, Croatia

  27. A TREATMENT AND OUTCOMES ANALYSIS OF PATIENTS WITH COCCYDYNIA N. Elezović, S. Ljubičić, M. Carev, B. Duplančić Anestheziology and Intensive Care, Clinical Hospital Split, Croatia POSTTRAUMATIC STRESS DISORDER AND CHRONIC PAIN M. Braš, Z. Lončar, M. Boban Clinic for Psichological Medicine, University Hospital Centre Zagreb, Zagreb Croatia, Pain Clinic, University Hospital of Traumatology, Zagreb, Croatia, Psychiatric Clinic, Clinical Hospital “Sestre Milosrdnice” Zagreb, Croatia EFFICACY OF PAIN COPING STRATEGIES IN ACUTE AND CHRONIC PAIN PATIENTS M. Havelka, A. Havelka Meštrović, M. Bilić Department of Helath Psychology, Universitiy of Applied Health Studies, Zagreb, Croatia, Psychiatry Clinic, Dubrava Clinical Hospital, Zagreb

  28. Our Society for Pain Management has been working intensively on educational programs for health care professions, patients, and common people and on recognition of the society in Croatia, Europe and world wide.

  29. The 2nd Congress of the Croatian Society for Pain 7. - 9. october 2010. • HOTEL OSIJEK • OSIJEK Predsident HDLB 2009 Prim.dr. Mira Fingler

  30. Thanks for your attention

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