title: [Home care treatment of cancer pain patients with patient-controlled analgesia (PCA)].
abstract: BACKGROUND
  Only limited data and experience with patient-controlled analgesia (PCA) in outpatients for palliative home care, related to organization, effectiveness and costs are available.
  
  
  METHODS
  In our retrospective study we analyzed the effectiveness, care intensity and pain reduction of 108 palliative cancer pain patients with PCA, included in a palliative home care system.
  
  
  RESULTS
  After equivalent conversion of the opioid doses from oral/transcutaneus to parenteral administration a dose increase was necessary in 12.9% of the patients. The pain therapy was effective until death for an average of 38.9 days (median 21 days). During 3,889 days of PCA therapy there were 76 unscheduled visits based on technical problems.
  
  
  CONCLUSIONS
  In cases of cancer pain patients with failed oral or transcutaneous opioid medication, sufficient pain reduction can be achieved with parenteral  drug administration by PCA. Domestic PCA requires a lot of human and financial resources, with trained nursing services and regular house visits by physicians experienced in palliative medicine but this method is sufficient and safe to use.
authors: Klinik für Schmerz- und Palliativmedizin, Klinikum Lünen - St.-Marien-Hospital, Altstadtstr. 23, 44534, Lünen, Deutschland. drlux@web.de
authors: E A
authors: EA
authors: Lux
authors: J
authors: J
authors: Heine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled / Q000191:economics / Q000295:instrumentation; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D057915:Drug Substitution; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000401:mortality / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement / Q000187:drug effects; D010166:Palliative Care / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid