LAW 38/2010 AND COMMUNITY NURSING: THE IFOC/IFEC AS MISSING GATEWAY TO ITALY'S PAIN THERAPY NETWORK

G. Fedelfranco¹, F. Germini² | ¹Social Health Local District of Bari, Unified Access Point (PUA) / Multidimensional Assessment Unit (UVM), Bari; University of Bari "Aldo Moro", Bari, Italy; ²Director Health Profession, Social Health Local District n. 10 of Bari, Bari, Italy

Abstract

Background and Aims. Italy's Law 38/2010 established citizens' right to access palliative care and pain therapy as essential levels of care. Fourteen years later, Violini et al. (Pain Res Manag 2025; DOI:10.1155/prm/3401242) confirm this landmark law has produced very few achievements for the real benefit of relieving chronic pain in the population compared with expectations. The IFoC (Infermiere di Famiglia o Comunità), mandated by DM 77/2022 with approximately 3,000 patients per nurse, is strategically positioned to function as the missing gateway between citizens and the pain therapy network. This study aims to assess whether IFoC systematically identify and refer chronic pain patients to Law 38/2010 network centers in Bari province.
Methods. Mixed-methods implementation study. Phase 1: retrospective audit of U.O. PUA/UVM referral records (January–December 2025; target N=200 multidimensional assessments): extraction of pain-related documentation, NRS recording, and pain center referrals generated. Phase 2: semi-structured interviews with IFoC (N=15, ASL Bari) and MMG (N=10) on awareness of the local Law 38 network and referral practice barriers. Ethical approval: ASL Bari IRB
Results. Preliminary audit (N=58 records): pain documentation present in 29.3%; NRS recorded in 15.5%; referral to the pain network under Law 38/2010 generated in 3.4%. IFoC interviews (N=8): 62.5% were unaware of local pain therapy center contacts; zero had received Law 38 training in the past 3 years.
Conclusions. The IFoC is the closest professional to the chronic pain patient yet remains structurally disconnected from Italy's pain therapy network. A structured Law 38/2010 integration protocol within DM 77/2022 territorial care frameworks is urgently needed.