Provision for advanced pain management techniques in adult palliative care: a national survey of anaesthetic pain specialists.
BACKGROUND
It is estimated that 8% of cancer patients could benefit from advanced pain management techniques; some 12,000 patients per year in the UK. In 2002, Linklater et al. surveyed palliative medicine consultants to assess their access and attitude to such techniques, finding under-utilization with a lack of formal arrangements for referral. We report a survey of pain specialist anaesthetists on the same topic.


METHODS
Postal questionnaire survey of lead anaesthetists in UK pain clinics.


RESULTS
106 responses were received from 170 questionnaires sent (62%). Referral rates from palliative medicine to pain clinics were low; only 31% of respondents received more than 12 per year. Joint consulting arrangements were rare, but were associated with more referrals. Only 25% of anaesthetists' job plans had time allocated for palliative medicine referrals, but where present this correlated positively with referrals received (P <0.002). Total interventions were estimated at less than 1000 per year.


CONCLUSIONS
There is evidence of under-referral of patients for advanced pain management procedures with a lack of integrated services.
Myton Hospice, Warwick, UK.
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Kay
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Husbands
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Antrobus
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Munday
D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D000776:Anesthesiology; D003695:Delivery of Health Care; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D010166:Palliative Care / Q000379:methods*; D010818:Practice Patterns, Physicians'; D006113:United Kingdom
D000700:Analgesics