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The European Journal of Public Health Advance Access published online on September 8, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki033
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received March 30, 2004
Accepted July 7, 2004

Article

Pain in primary care: an Italian survey

Daniela Koleva 1, Iva Krulichova 1, Guido Bertolini 2, Vittorio Caimi 3, and Livio Garattini 1*

1 CESAV, Centre for Health Economics, Mario Negri Institute for Pharmacological Research, Ranica, Italy
2 Clinical Epidemiology Laboratory, Mario Negri Institute for Pharmacological Research, Ranica, Italy
3 CSeRMEG, Centre for Research in General Practice, Monza, Italy

* To whom correspondence should be addressed.
Livio Garattini, E-mail: lgarattini{at}marionegri.it


  Abstract

Background: Pain is a universal symptom of various pathologies and largely affects human well-being. Pain is therefore commonly observed by general practitioners (GPs) and its management is a useful indicator of quality. In our study we investigated the epidemiology and management of pain in Italian general practice. Methods: Participating GPs were asked to record the first out of every two contacts with pain during two working weeks between November 2000 and February 2001. They entered information on type of pain, pain-related diagnosis, certainty of diagnosis and types of prescription. Results: 89 GPs participated in the study. About one third of all reported contacts were with pain. The number of contacts analysed was 1432. Nearly half the cases were diagnosed as acute. The main complaints were of musculoskeletal and abdominal origin. Pain was 1.5 times more frequent in women than men and the female to male ratios for acute and chronic pain were 1.2:1 and 1.8:1 respectively. The most frequent site of pain was the limbs. ‘Arthropathies and related disorders’, ‘dorsopathies’ and ‘rheumatism excluding the back’ were the commonest groups of diagnoses. Approximately two thirds of contacts with pain led to a drug prescription. Conclusions: The study identified a high proportion of contacts with pain in Italian general practice, with widespread use of drugs. The distribution of chronic and acute pain was rather similar and musculoskeletal pain was the most frequent form. Most types of prescriptions were closely related to certainty of diagnosis.

Keywords: Italy; general practice; pain; pain management; NSAIDs.
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