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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 January;83(1):12-22

DOI: 10.23736/S0375-9393.16.10999-X

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Characteristics and outcomes of chronic pain patients referred to hospital pain clinics: a prospective observational study

Sebastián VIDELA 1, Elena CATALÀ 2, María V. RIBERA 3, Antonio MONTES 4, Daniel SAMPER 5, José FUENTES 6, Carmen BUSQUETS 7 , on behalf of Pain Units of Hospitals in Catalonia Group 

1 Department of Experimental and Health Sciences, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; 2 Pain Unit, Hospital de la Santa Créu i Sant Pau, Barcelona, Spain; 3 Pain Unit, Hospital Vall d’Hebrón, Barcelona, Spain; 4 Pain Unit, Hospital del Mar, Barcelona, Spain; 5 Pain Unit, Hospital Germans Trias i Pujol, Badalona, Spain; 6 Pain Unit, Pius Hospital, Valls, Spain; 7 Pain Unit, Hospital Clínic, Barcelona, Spain


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BACKGROUND: Understanding the patient referral patterns and medical profiles of patients attending hospital pain clinics, and the therapies offered to them, can provide a useful starting point for evaluating their effectiveness and identifying areas for improvement.
METHODS: A prospective observational study was carried out. Sociodemographic and clinical data were gathered at twelve centres. The diagnoses and pain treatments provided by the referring doctors were compared with the ones provided by pain clinicians. Pain severity and patients’ quality of life were measured prospectively. Descriptive statistics were compared.
RESULTS: Two-hundred sixty-nine patients referred to 12 outpatient hospital pain clinics in Catalonia were followed for 3 months. Most were referred by orthopaedists (50.0%) or primary care physicians (20.2%). The mean age and time since pain onset were 59.4 and 4.1 years, respectively. Pain clinicians changed the diagnostic labels of 48.5% of the patients. Nearly all patients (89.2%) were receiving pain medications prior to referral. Treatment was modified in 94.8%. Pain clinicians used more interventional and/or alternative therapies (65.1% of patients), opioids (46.8%) and co-adjuvants (38.2%). Three months after referral, the 24-h worst and current pain severity had decreased by 30.9% and 27.8% on average, respectively. The mean (effect size) improvements in a quality of life (the EuroQol 5 Dimensions index) and pain (visual analogue scale) scores were, respectively, 0.16 (0.73) and 6.7 (0.31).
CONCLUSIONS: Pain clinicians refined the diagnoses and treatments of patients referred to hospital pain clinics and improved outcomes. Relatively few patients are referred from primary care considering the prevalence of chronic pain in this setting.


KEY WORDS: Observational study - Outcome assessment (Health Care) - Pain - Pain clinics - Pharmacoepidemiology - Prevalence - Referral and consultation

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Publication History

Issue published online: January 19, 2017
Article first published online: April 13, 2016
Manuscript accepted: April 12, 2016
Manuscript revised: April 8, 2016
Manuscript received: October 23, 2015

Cite this article as

Videla S, Català E, Ribera MV, Montes A, Samper D, Fuentes J, et al.; Pain Units of Hospitals in Catalonia Group. Characteristics and outcomes of chronic pain patients referred to hospital pain clinics: a prospective observational study. Minerva Anestesiol 2017;83:12-22. DOI: 10.23736/S0375-9393.16.10999-X

Pain Units of Hospitals in Catalonia Group

Mercé GENOVÉ, Pain Unit of Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Maria D. FERRER, Pain Unit of Hospital del Mar, Barcelona, Spain; Josep VILAPLANA, Antoni ARXER, Pain Unit of Hospital Dr. Josep Trueta, Girona, Spain; Lluis LLORENTE, Pain Unit of Hospital General de Catalunya, Barcelona, Spain; José ARÉN, Pain Unit of Hospital General de Granollers, Barcelona, Spain; Roser ALOMÀ, Joan COMA, Pain Unit of Hospital General de l’Hospitalet, Barcelona, Spain; Gisela ROCA, Pain Unit of Hospital Germans Trias i Pujol de Badalona, Barcelona, Spain; Dolors SINTES, Helena BARCELÓ, Pain Unit of Hospital Municipal de Badalona, Barcelona, Spain; Antonio MONTERO, Mercé MATUTE, Pain Unit of Hospital Universitari Arnau de Vilanova, Lleida, Spain; Víctor MAYORAL, Miquel CASALS, Pain Unit of Hospital Universitari de Bellvitge, Barcelona, Spain; Maria RULL, Pain Unit of Hospital Universitari Joan XXIII, Tarragona, Spain; Vicente DE SANCTIS, Laura RUIZ-VILLA, Pain Unit of Hospital Universitari Sagrat Cor, Barcelona, Spain; Javier MEDEL, Pain Unit of Hospital Vall d’Hebron, Barcelona, Spain; Jesús VILLORIA, Raquel JEREZ, Biometrics & Medical Writing CRO, MEDICxact, Madrid, Spain; Esther ORTIZ, Monitor freelance, Barcelona, Spain

Corresponding author e-mail

sebastia.videla@upf.edu