Research Article

Pain as a disease in the new International Classification of Diseases (ICD-11): Latin American expert consensus

*Author for correspondence:

E-mail Address: marcoanarvaezt@gmail.com

Specialist in Anesthesiology & Pain Medicine, Coordinator of the Pain Unit, Hospital Obrero Nro. 1-Hospital Materno Infantil, Caja Nacional de Salud. La Paz, Bolivia, President of the Latin American Federation of Associations for the Study of Pain (FEDELAT), President of the Bolivian Pain Association

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Carlos Aguayo

Specialist in Anesthesiology, Head of the Pain Unit, Hospital Clínico FUSAT. Rancagua, Chile. President of the Chilean Association for the Study of Pain & Palliative Care

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Elias Atencio

Specialist in Anesthesiology, Head of the Algiology Service, Complejo Hospitalario ‘Dr. Arnulfo Arias Madrid’, Panamá. Former President of the Latin American Federation of Associations for the Study of Pain (FEDELAT)

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Joao Batista Garcia

Specialist in Anesthesiology, Pain Medicine & Palliative Care, Universidad Federal de São Luís, Brasil

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Carmen Cabrera

Specialist in Anesthesiology, Pain Medicine & Interventional Medicine, Pain Therapy & Palliative Care Service.Hospital Alberto Sabogal Sologuren-Essalud, Bellavista, Perú

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Celina Castañeda

Specialist in Anesthesiology & Palliative Medicine, Teacher at the Faculty of Medicine of the Universidad Autónoma del Estado de México, Undersecretary of Health, Tlaxcala State, México

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Pablo Castroman

Specialist in Anesthesiology, Associate Professor of Anesthesiology, Pain Therapy Service, Department & Chair of Anesthesiology, Hospital de Clínicas, University of Medicine, Universidad de la República, Uruguay, Relevium Co-Founder, Pain Medicine, Montevideo, Uruguay

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Graciela Elizeche

Specialist in Anesthesiology, Founder & former President of the Paraguayan Association for the Study & Treatment of Pain, Paraguay

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Patricia Gomez

Specialist in Anesthesiology, Pain Management & Palliative Care, Associate Professor, Anesthesia Unit, Department of Surgery, Universidad Nacional de Colombia. Bogotá D.C., Colombia

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Santiago Guaycochea

Specialist in Internal Medicine & Medical Clinic, Head of Pain Medicine, Sanatorio Otamendi. Buenos Aires, Argentina, President of the Argentine Association for the Study of Pain

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Marixa Guerrero

Specialist in Anesthesiology, Epidemiology, Pain Medicine & Palliative Care, General Director of Oncology Clinic Colsubsidio 127, Bogota, Colombia, Member of the Board of Directors of the Colombian Association for the Study of Pain, Coordinator of the Epidemiology Committee of Latin American Federation of Associations for the Study of Pain (FEDELAT)

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Rocio Guillen

Specialist in Anesthesiology, Interventional Medicine, Pain Medicine & Palliative Care, Pain Clinic of the Instituto Nacional de Cancerología, México, Director General of Clínica Alive ‘Vive sin Dolor’, Ciudad de México, México, Former President of the Mexican Association for the Study & Treatment of Pain, Member of the Latin American Federation of Associations for the Study of Pain (FEDELAT)

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Carla Leal Pereira

Specialist in Anesthesiology, Technical supervisor, Pain service. Hospital São Luiz/Rede D’Or. Brasil. Director General of the Pain Service in MedDor – São Paulo/Brasil, Fiscal Council Brazilian Society for the Study of Pain, Brasil, Member of the Latin American Federation of Associations for the Study of Pain (FEDELAT)

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Guillermo López

Specialist in Anesthesiology & Resuscitation, Adjunct Professor of Anesthesiology Postgraduate, Universidad de Cuenca. Director of the UnitDolor AMETS, Hospital Universitario del Río, Cuenca, Ecuador

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Jacqueline Macias

Specialist in Anesthesiology & Pain Treatment, RELIF Director ‘Centro de Tratamiento del Dolor y Medicina Paliativa’, Past President of the Ecuadorian Society for the Study & Treatment of Pain, Ecuador

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Bethania Martinez

Specialist in Anesthesiology, Pain Management & Palliative Care, Interventional Pain & Palliative Care Unit (UNIDOLOR SRL), Santo Domingo, Dominican Republic

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Felipe Mejia

Specialist in Anesthesiology, Fellow in Interventionism in Pain & Palliative Care. Program Director of Dolor Neurocentro Pereira Colombia, President of Colombian Association for the Study of Pain, Colombia.

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Enrique Orrillo

Neurology Specialist, Professor & Coordinator of the Diploma in Chronic Pain at the Universidad Nacional Mayor de San Marcos de Lima, Perú, President of the Peruvian Association for the Study of Pain

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José O Oliveira

Neurosurgery Specialist, Neurosurgery Service of Hospital Servidor Público Estadual, President of the Brazilian Society for the Study of Pain, Brasil

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Fabian Piedimonte

Specialist in Neurosurgery, Professor of the Faculty of Medicine, Universidad de Buenos Aires, President of the CENIT Foundation for Research in Neurosciences, Argentina

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Francisco Samayoa

Specialist in Anesthesiology, Associate Professor, Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras, Career Coordinator of the Postgraduate Course in Anesthesiology, Resuscitation & Pain, President of the Honduran Society of Anesthesiology, Resuscitation & Pain, Honduras

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Martin Toro

Specialist in Anesthesiology, Professor of Pain Medicine & Regional Anesthesia.Universidad Central de Venezuela, President of the Venezuelan Association for the Study of Pain, Venezuela

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Published Online:21 Feb 2024https://doi.org/10.2217/pmt-2023-0096

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Abstract

Aims: Pain diagnoses in the 10th version of the International Classification of Diseases (ICD-10) did not adequately support the current management of pain. Therefore, we aimed to review the new 11th revision (ICD-11) in order to analyze its usefulness for the management, coding, research and education of chronic pain from a Latin American perspective. Methods: The Latin American Federation of Associations for the Study of Pain convened a meeting of pain experts in Lima, Peru. Pain specialists from 14 Latin American countries attended the consensus meeting. Results: In ICD-11, chronic pain is defined as pain that persists or recurs longer than 3 months and is subdivided into seven categories: chronic primary pain and six types of chronic secondary pain. Chronic primary pain is now considered a disease in itself, and not a mere symptom of an underlying disease. Conclusion: The novel definition and classification of chronic pain in ICD-11 is helpful for better medical care, research and health statistics. ICD-11 will improve chronic pain management in Latin American countries, for both the pain specialist and the primary care physician.

Plain language summary

Chronic pain is one of the most frequent reasons for medical consultation in Latin America. In the tenth revision of the International Classification of Diseases and Related Health Problems (ICD-10), chronic pain was not adequately defined and individual pain diagnoses were poorly defined.

For the first time in Latin America, a meeting of pain experts analyzed and reviewed the 11th version of the International Classification of Diseases (ICD-11), when the Latin America Federation of Associations for the Study of Pain organized a meeting of experts from 14 Latin American countries.

In ICD-11, chronic pain is recognized as a biopsychosocial phenomenon and defined as pain that continues or returns for more than 3 months. It is split into seven types: chronic primary pain and six types of chronic secondary pain. In ICD-11, chronic primary pain is now considered a disease in itself, not a mere manifestation of other disease.

Our article is the first to address the problems, challenges and benefits of using ICD-11 from a Latin American perspective. It will help to facilitate and disseminate the use of this new classification of chronic pain. This will improve chronic pain treatment, statistics, research and development of better health strategies for pain management in Latin America.

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 14, No. 3

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History

Received 29 September 2023

Accepted 25 January 2024

Published online 21 February 2024

Published in print March 2024

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Keywords

Author contributions

All authors contributed extensively to the work presented in this paper. All authors have contributed significantly to the conception, design, or acquisition of data, or analysis and interpretation of data. All authors have participated in in drafting, reviewing and/or revising the manuscript and have approved its submission.

Acknowledgments

The authors thank the LatAm Pain Associations participating in the consensus: Argentine Association for the Study of Pain; Latin American Federation of Associations for the Study of Pain (FEDELAT); Brazilian Society for the Study of Pain, Chilean Association for the Study of Pain and Palliative Care, Colombian Association for the Study of Pain; Ecuadorian Society for the Study and Treatment of Pain; Honduran Society for the Study and Treatment of Pain; Mexican Association for the Study and Treatment of Pain; Paraguayan Association for the Study and Treatment of Pain; Peruvian Association for the Study of Pain; Venezuelan Association for the Study of Pain.

Financial disclosure

This manuscript is based on a meeting of a panel of experts in Lima, Peru, within the framework of the XIV Latin American Congress on Pain that was sponsored by Grünenthal LATAM. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

Writing assistance was provided by Content Ed Net with funding from the Latin American Federation of Associations for the Study of Pain (FEDELAT) and Grünenthal LATAM.

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