[Organisation of postoperative acute pain therapy in Germany compared to other European nations - results of a postoperative analgetic therapy observational survey (PATHOS)].
BACKGROUND
From 2004 to 2005, a survey concerning the structure and organisation of postoperative acute pain therapy (APT) was conducted in 1358 hospitals from 7 EU states.


METHODS
Anaesthesiologists, general and abdominal surgeons, orthopaedic / trauma surgeons, gynaecologists and ENT specialists were interviewed concerning: Education of medical and non-medical employees, patient information, protocols for acute pain therapy and methods of pain assessment.


RESULTS
1558 questionnaires from 746 hospitals were returned, among them 516 questionnaires from Germany where surgeons were more often responsible for acute pain therapy (50 vs. 36 %, p < 0.05). A budget for APT existed in only 8 % of German hospitals (vs. 22 % of hospitals in other nations, p < 0.05). German surgeons were more often responsible for the APT education of nurses on the general ward (58 vs. 20 %, p < 0.05). Patient information about APT was more often presented in Germany in selected cases (45 vs. 23 %, p < 0.05), APT protocols were developed more often (42 vs. 30 %, p < 0.05) and the influence of APT on morbidity and mortality was judged to be higher by German physicians (p < 0.05 each) as compared to other nations. Nevertheless, postoperative pain was not assessed at all in 53 % of all German hospitals, and only in 25 % of the hospitals of other nations (p < 0.05).


CONCLUSIONS
Further initiatives to improve postoperative acute pain therapy are urgently needed in all nations under evaluation. National measures in Germany have to take into account the specific problems identified in this large survey and should focus on the interests and needs of German surgeons.
Universitätsklinik für Allgemein-, Viszeral-, Gefäss- und Thoraxchirurgie, Universitätsmedizin Berlin, Charité Campus Mitte. wolfgang.schwenk@charite.de
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Brodner
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Neugebauer
D000208:Acute Disease; D000700:Analgesics / Q000627:therapeutic use*; D019091:Critical Pathways / Q000458:organization & administration; D003431:Cross-Cultural Comparison; D004363:Drug Utilization / Q000706:statistics & numerical data; D004501:Education, Medical; D005060:Europe; D013502:General Surgery / Q000193:education; D005858:Germany; D006306:Health Surveys; D006801:Humans; D007318:Inservice Training; D009741:Nursing Staff, Hospital / Q000193:education; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy* / Q000401:mortality; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016019:Survival Analysis
D000700:Analgesics