[Clinical pain consultation. Profiles of clinical pain consultation and requirements for management of complex pain patients in inpatient care]

Abstract

Background: The aim of this investigation was to describe the performance profile and the requirements for the management of complex pain patients for the structures of a consultation service.

Material and methods: The content and number of all inpatient consultations of the pain department (as an independent service in addition to acute pain and palliative care services) were evaluated for the period from 2008-2010.

Results: During the study, 1,391 contacts were made in 882 patients; in approx. 50% of the consultations diagnostic or specific (interventional) procedures were requested. Beside additional diagnostic tests, physiotherapy (19.2%), psychological and psychiatric care (11.1%), and other therapeutic approaches (e.g., mirror therapy, transcutaneous electrical nerve stimulation, progressive muscle relaxation) or the long-term follow-up in specialized pain service (20.5%) were recommended.

Conclusion: Within the scope of the pain consultation, a wide spectrum of pain diagnoses and difficult patients are examined. Mixed forms of acute, chronic, and tumor-related pain are often present. Therapeutically, optimization of only the pharmacological regimen is often not sufficient. Similar requirements for a multimodal diagnosis and therapeutic concept as established in ambulatory and/or specialist care are ultimately needed.