Jun 13, 2016
On April 4, 1991, the Pain Treatment Unit at Funchal Hospital in Madeira Island, Portugal, began treating patients. The hospital is 1,000 km distant from the European Mainland, and serves a population of 270,000 inhabitants.
Adopting IASP guidelines and recommendations, a multidisciplinary team was organized and provided with pain medicine training. Founded by three young doctors (two anesthesiologists and one psychiatrist) under the motto “Pain Treatment, a Right and Duty,” this team introduced an approach in the hospital’s clinical practice in accordance with the biopsychosocial model, applying techniques and specific methodologies aimed at reinserting patients into their familiar social and working environment.
Along the years, there was the need to diversify and enlarge the unit’s activities, considering the growing demand of patients. Thus, a multidisciplinary pain clinic was created to treat acute pain and chronic pain in different units.
In 2015, a major restructuring took place, and the Centro Multidisplinar de Medicina da Dor Dr. Rui Silva, was provided with the capacity, resources, and technical skils to treat complex pain of different types and etiologies. The unit also adopted clinical rules based on EBM (Evidence-Based Medicine), with regular evaluations. This led to a significant and important increase on the number of patients (around 10,000 procedures per year).
In May 2000, and in direct collaboration with the hospital’s primary care unit, a new project began titled Um Hospital na Comunidade (A Hospital in the Community). This project took into consideration the geography of the island, its challenging accessibility to several areas, and the aging of the population. Members of the primary care team have organized daily visits to individual homes in collaboration with the local primary health-care teams, particularly with general practitioners, nurses and other health-care providers.
The main goals of Um Hospital na Comunidade are not only to provide patients with total support to control pain and restore their functional capacity and ability but also to support the patient’s family and caregivers, thus decreasing or avoiding hospital admissions, promoting the autonomy of these individuals, and establishing partnerships with the primary care centers.
Now, 25 years after the establishment of the first pain treatment unit at Funchal, we have commemorated its founding with several workshops, debates, panels, and symposia to discuss the state of art in pain treatment in a multidisciplinary and interdisciplinary way.
Among the speakers at the three-day event in April were IASP President Rolf-Detlef Treede, IASP Councilor José Castro Lopes, ESRA President José de Andes,and Beatriz Craveiro Lopes, president of the Portuguese Medical College of Pain Medicine.
The Health Secretary of the Madeira government presided over the opening ceremony, and IASP President Treede made a presentation titled “New medications against neuropathic pain: how to close the translation gaps,”which constituted the most prestigious moment of this meeting.
This meeting was aimed at all the professionals interested in pain treatment in Madeira Island, and it was attended by 250 people most of them young doctors (residents or fellows) and general practitioners. During the conference, a simple but deep homage was made to Rui Silva (a founding member) and Emanuel Gomes (the psychologist team member) both of whom are now deceased.
Last month, the eight political parties with a seat at the Local Autonomous Parliament unanimously voted a motion to congratulate the pain center’s activities during these 25 years, recognizing explicitly that pain treatment is a citizen’s right.
--Dr. Duarte Correia is president of the Portuguese Association for the Study of Pain (APED).