Pain management services in palliative care: a national survey

Linklater, Gordon; Leng, Mhoira; Tiernan, Eoin; Lee, M. A.; Chambers, W. A.

doi:10.1191/0269216302pm535oa

Cited by 23 publications

(15 citation statements)

References 15 publications

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“…[18][19][20] There is a scarcity of literature on the subject of the interface between pain services and palliative medicine services for cancer pain, with only two national surveys having been published since 2002. 21,22 As both these surveys are now fairly outdated, it is difficult to ascertain whether effective provision of services for cancer pain exists.…”

Section: Interface Between Pain Medicine and Specialist Palliative Carementioning

confidence: 99%

“…While they thought that up to 8% of patients may benefit from an interventional procedure, only 20% of palliative care doctors believed that more input from pain specialists was required. 21 A variety of reasons for this apparent under-utilisation are proposed, including a lack of formal structures, geographical isolation of hospice units, different management and governance structures between the services and a lack of experience among palliative medicine physicians.…”

Section: Interface Between Pain Medicine and Specialist Palliative Carementioning

confidence: 99%

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Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

O’Brien

Kane

2014

British Journal of Pain

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The vast majority of cancer patients will experience pain during the course of their illness. Thankfully, in most instances, the consistent application of analgesic guidelines, tailored to the unique needs of each individual patient, will deliver a satisfactory outcome. These guidelines recommend the skilled use of analgesic medications, often in conjunction with a range of adjuvant therapies as may be required. Despite the consistent and rational application of such strategies, it is recognised that a small but significant proportion of cancer patients continue to experience more refractory pain. In addition, these patients may experience a plethora of unwanted dose-limiting side effects associated with their analgesic medication, sometimes even at low dose. All such patients with more complex and refractory pain syndromes require a more comprehensive review and many will require interventional therapy and/or adjuvant approaches. Unfortunately, the availability and accessibility of such services are variable. Even in circumstances in which palliative medicine and pain services co-exist in the same region, there may be poor integration between the two services. Each specialty area holds a unique set of skills and competencies, yet there is considerable overlap. Patient care and outcomes will be enhanced by establishing more formal relationships between these two specialty areas.

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Section: Interface Between Pain Medicine and Specialist Palliative Carementioning

confidence: 99%

Section: Interface Between Pain Medicine and Specialist Palliative Carementioning

confidence: 99%

Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

O’Brien

Kane

2014

British Journal of Pain

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“…B. Schmerz, Übelkeit, Erbrechen, Agitation, Dyspnoe), der Umgang mit Krisensituationen sowie ethische Fragestellungen beispielsweise bezüglich Therapieindikation bzw. -reduktion sind in unterschiedlichen Bereichen der Anäs-thesiologie in der täglichen Routine gegeben [3,5,11,12,16,17,18,19,22,23,32]. Eine Übertragbarkeit anästhesiologisch-therapeutischer Optionen ist -allerdings mit zusätzlichen palliativmedizinischen Aspekten (beispielsweise Berücksichtigung psychosozialer und spiritueller Faktoren) -in der Palliativmedizin durchaus denkbar.…”

Section: Vergleich Der Weiterbildungsinhalte Anästhesiologischer Zusaunclassified

“…Die Anästhesiologie kann mit ihren einzelnen Subspezialisierungen und weitreichenden Erfahrungen in der Kooperation mit anderen Fachdisziplinen und Professionen für eine solche Therapiekoordination hilfreich sein [4,5,9,11,16,17,18,20,37]. Aufgrund der bereits bestehenden Vielseitigkeit des Faches und der breiten fachlichen Herausforderungen in der täglichen Klinikroutine sollte die Palliativmedizin für Anästhesisten als koordinierende Instanz keine unlösbare Aufgabe darstellen.…”

Section: Bedeutung Einer Anästhesiologischen Abteilung Für Die Palliaunclassified

Palliativmedizin

et al. 2009

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Palliative medicine has progressed during recent years to an independent medical faculty within the German health system. Despite this development palliative care systems for out-of-hospital and in-hospital palliative care are still insufficient in Germany so that the development of necessary resources must be considered as not yet completed. To support the further national development palliative medicine can be temporarily or permanently coupled to existing departments, which can be advantageous for all concerned and last but not least be profitable to patients and their relatives. Possibilities for participation of anaesthesiologists in this area of medical care are discussed in the study reported here. Anaesthesiologists have always historically been represented in palliative medical departments, e.g. as pain specialists. In the following investigation the special possibilities of anaesthesia departments for supporting the education and development of in-hospital and out-of hospital palliative medical care departments are reported. Previous experience of co-operation between these two departments is well established. Departments of palliative medicine depend on a well working interdisciplinary co-operation between different medical disciplines (e.g. anaesthesiology, radiotherapy, surgery and oncology) and several medical professions (e.g. physicians, nurses, psychologists). The aim of palliative care therapy is to be responsible for the best possible therapy for cancer patients and to give support to their care-giving relatives. Due to the increasing establishment of palliative care procedures in Germany, departments of anaesthesiology should actively take part in the further development. Part of the responsibility of most anaesthesia departments is to practice pain management and critical care medicine, which are reasons why anaesthesiologists are predestined to be part of the system for palliative care patients and their relatives. Anaesthesia departments can be responsible for the organization of in-hospital and out-of-hospital palliative medicine and palliative care. The integration of anaesthesiological expertise into palliative medicine departments and vice versa can be a great opportunity for both medical departments and therefore represents a worthwhile engagement.

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“…Der Grundgedanke der modernen Palliativmedizin in Deutschland entstand primär basierend auf einer allgemein nicht ausreichenden innerklinischen schmerztherapeutischen Versorgung von Patienten mit Tumorerkrankungen [2,3,4]. Diese erfolgte international in der ersten Phase überwiegend durch konsiliarische innerklinische Schmerzdienste, welche oftmals in anästhesiologisch geleitete Schmerzkliniken, Schmerzambulanzen und konsiliarische Schmerz dienste integriert waren [5,6]. Aus diesen entwickelten sich in der Folge sog.…”

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Anästhesiologie und Palliativmedizin

Wiese

Felber

Lassen

et al. 2011

Schmerz

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Until 2005 many university palliative care activities had their origins in cancer pain services. These were often integrated into anesthesiology departments. Currently, anesthesiology departments work as an integrative part of palliative medicine. However, it appears from the present results that there is a domination of internal medicine (especially hematology and oncology) in palliative activities in German hospitals. This allows the focus of palliative activities to be formed by subjective specialist interests. Such a state seems to be reduced by the integration of anesthesiology departments because of their neutrality with respect to faculty-specific medical interests. Advantages or disadvantages of these circumstances are not considered by the present investigation.

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Pain management services in palliative care: a national survey

Cited by 23 publications

References 15 publications

Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

Palliativmedizin

Anästhesiologie und Palliativmedizin

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