Out-patient chronic pain service in Hong Kong: prospective study.
OBJECTIVE
To examine the profile and referral pattern of patients attending an out-patient pain management service in Hong Kong.


METHODS
Prospective cross-sectional survey.


METHODS
Regional public hospitals, Hong Kong.


METHODS
All patients attending out-patient pain management clinics in the New Territories East public hospitals between 1 September and 31 December 2002.


METHODS
Demographic profiles, referring specialty, pain diagnosis, pain sites, duration and severity of pain, treatment modality, litigation, compensation, and social welfare status. Data were collected using a standardised questionnaire.


RESULTS
Two hundred and forty-eight patients were interviewed. Most patients (70%) were middle-aged, with 21% over 60 years. Seventy-nine percent of patients were referred to the clinics either from orthopaedic surgeons (64.1%), general and other surgeons (14.9%), or general practitioners (3.6%). The median (range) duration of pain was 2.3 (0.08-26.7) years. The most common pain diagnoses were musculoskeletal back pain (46.4%) and neuropathic pain (27.8%). A total of 11.3% of the patients had two pain diagnoses, while 40.7% complained of pain in more than one location. Pain in the limbs was the most frequent complaint followed by the head, neck, and back. Approximately 38% of patients had tried four or more treatment modalities. Oral medication was the most common method (86.7%) of pain-relief treatment. More than half of the patients had also tried physiotherapy and traditional Chinese medicine. Approximately 37% of the patients were unemployed, while 31% were receiving social security subsidy. Eighty-six patients had pain associated with a work-related injury, and of these patients, 80% were involved in compensation claims.


CONCLUSIONS
The profile of patients referred to the pain management clinics was complex. Patients were mainly referred from specialists. The economic implication in this group of patients is likely to be significant as many patients utilised multiple treatment modalities, were unemployed and on social welfare benefits, and were involved in compensation and litigation proceedings.
Chen
P P
PP
Division of Pain Medicine, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ppchen@cuhk.edu.hk
Chen
J
J
Gin
T
T
Ma
M
M
Fung
K C
KC
Woo
K H
KH
Wong
P Y
PY
D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D019538:Health Care Surveys; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications; D009784:Occupational Diseases / Q000628:therapy; D010044:Outpatient Clinics, Hospital; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010523:Peripheral Nervous System Diseases / Q000150:complications; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012943:Social Security / Q000706:statistics & numerical data; D014942:Workers' Compensation