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

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: :

• chronic
• classification
• ICD-11
• Latin America
• management
• pain

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.