title: National survey of pain clinics in Croatia: Organization and services.
abstract: OBJECTIVE
  To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia.
  
  
  METHODS
  Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires.
  
  
  RESULTS
  Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard--the systematic reviews of The Cochrane Collaboration--were used less frequently (n=12; 57%) than advertising materials from pharmaceutical companies (n=16; 76%). Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project.
  
  
  CONCLUSIONS
  The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice.
authors.affiliation: Faculty of Medicine, University of Tuzla, Bosnia and Herzegovina.
authors.forename: Mahir
authors.initials: M
authors.lastname: Fidahić
authors.affiliation: Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.
authors.forename: Katarina
authors.initials: K
authors.lastname: Dogan
authors.affiliation: Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.
authors.forename: Damir
authors.initials: D
authors.lastname: Sapunar
authors.affiliation: Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia. livia@mefst.hr.
authors.forename: Livia
authors.initials: L
authors.lastname: Puljak
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D017523:Croatia / Q000453:epidemiology; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D055317:Evidence-Based Practice; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D010146:Pain / Q000453:epidemiology / Q000517:prevention & control*; D018710:Pain Clinics / Q000458:organization & administration / Q000592:standards; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires