The treatment of chronic pain in Québec: a study of hospital-based services offered within anesthesia departments

Abstract

P Pu ur rp po os se e: : Little or no information exists on the services that are currently available for the treatment of chronic pain across the different regions of Canada. As a first step, this study documented the hospital-based resources and services offered for the management of chronic non-cancer pain within anesthesia departments in Québec. M Me et th ho od ds s: :In collaboration with the Association of Anesthesiologists of Québec and the Société québécoise de la douleur, a provincial survey was conducted to assess the availability of services for chronic pain management within hospital-based anesthesia departments along with the volume of clinical activities, staff composition, treatments offered and space facilities.R Re es su ul lt ts s: : The response rate was 100%. Fifty of the 69 departments (73%) offered services for the management of chronic non-cancer pain but the services were often limited. Twenty-six percent (13/50) of the departments provided some form of multidisciplinary assessment and treatment but only three had a core team comprised of an anesthesiologist, a nurse, a psychologist, and a physical therapist. Examination of patient waiting lists of the surveyed departments revealed disturbing results: approximately 4,500 patients were waiting for their first appointment to see a pain consultant, and nearly 3,000 (67%) had been waiting for nine months or more.C Co on nc cl lu us si io on n: : Although this survey did not include the services offered in departments other than anesthesia, the results show the extent to which the province of Québec is under-resourced for the management of chronic pain patients both in terms of access to treatment and quality of the services offered. Objectif

The Canadian STOP-PAIN project – Part 1: Who are the patients on the waitlists of multidisciplinary pain treatment facilities?

“…Multidisciplinary pain treatment is recognized as the optimal paradigm 3,B for a good proportion of these patients, but access is restricted due to the limited number of facilities and long waiting lists. 4,5 A recent Canadian survey identified six months as the median wait time for a first appointment in public multidisciplinary pain treatment facilities (MPTFs). This means that 50% of patients have to wait six months or more (with a range of up to five years) for access to appropriate pain treatment, with 30% of clinics reporting waitlists of more than one year and vast areas of the country remaining unserviced.…”

Tomorrow and tomorrow and tomorrow: wait times for multidisciplinary pain clinics in Canada

“…A recent survey of hospital-based services for non-cancer pain treatment in Quebec found that almost 30% of anesthesiologists in that province were involved in treating chronic pain. 2 Approximately one Canadian in five suffers from chronic non-malignant pain, defined as pain present on most days, for a minimum of six months. The prevalence increases with age.…”

“…Veillette et al 2 studied pain clinic services within hospital-based anesthesia departments in Quebec and found that the province was underserved, both in terms of limited access and inadequate quality of services offered. In the latter six months of 2002, 4,500 patients were waiting for their first appointment in a pain clinic.…”

“…Un sondage récent des services basés en hôpital pour le traitement des douleurs non cancéreuses au Québec a démontré que presque 30 % des anesthésiologistes de cette province étaient impliqués d'une manière ou d'une autre dans le traitement des douleurs chroniques. 2 Environ un Canadien sur cinq souffre de douleur chronique non maligne, définie comme une douleur présente presque tous les jours pour une période d'au moins six mois. La prévalence augmente avec l'âge.…”

“…2 ont examiné les services de clinique de la douleur au sein des départements d'anesthésie dans les hôpitaux au Québec et ont conclu que la province n'était pas suffisamment desservie, que ce soit en termes d'accès limité ou de qualité inappropriée des services offerts. Durant la deuxième moitié de 2002, 4 500 patients attendaient leur premier rendez-vous dans une clinique de la douleur.…”