Організаційні можливості профілактики хронічного болю в пацієнтів із бойовою травмою на рівні первинної медичної допомоги в Україні

Chronic pain (CP) is considered by scientists as a model of disease. Initially, acute pain occurs as an unpleasant, dynamic psychophysiological process, usually in response to tissue injury and the associated inflammatory processes. After the period of acute danger passes, pain becomes an independent chronic disease. The objective: to study the organizational capabilities of a general practitioner – family doctor (GP-FD) within the framework of primary medical care in Ukraine to ensure the prevention of CP in patients with combat trauma. Materials and methods. The material for the study was scientific publications related to the topic of CP, regulatory documents that order the functions of a GP-FD in CP prevention. During the study, bibliosemantic and analytical methods were used. Results. The problem of CP as a result of inadequate and untimely treatment of acute pain in patients with combat trauma was analyzed at all stages of medical care: at the time of injury, during evacuation, in hospitals, at the post-hospital stage and during rehabilitation. It was found that CP is a common medical problem with a multidimensional dynamic interaction between biological (genetics, age, gender, hormonal status and endogenous opiate systems), psychological (depression, post-traumatic stress, imperfect coping skills and catastrophic perception of real events) and social (low level of education, culture, socialization of veterans) indicators. As a cause of disability, CP also interferes with a person’s ability to work and can lead to financial negative outcomes for a person who has participated in combat activities. In Ukraine, the continuity of analgesic therapy as a method of CP prevention is not observed due to the lack of standardized organizational technologies for the prevention of CP in patients with combat trauma, as well as special training of GP-FD to use modern technologies to prevent the occurrence of CP. Conclusions. In Ukraine, pain relief therapy by a GP-FD is provided within the framework of general functions for medical care. Organizational technologies (standardization of specific tasks for the prevention of CP, specialized training of specialists, quality monitoring) for the prevention of CP in patients with combat trauma within the framework of primary medical care are not defined, the problem is unresolved.