title: Pain is not systematically registered in Dutch medical oncology outpatients.
abstract: BACKGROUND
  Systematic pain registration and assessment with a visual analog scale (VAS) or numeric rating scale (NRS) at each visit are key recommendations in one of the most recent guidelines on cancer pain management. It is unclear whether this recommendation is applied.
  
  
  OBJECTIVE
  The aim was to explore registration of pain in medical records of patients visiting the medical oncology outpatient clinic.
  
  
  METHODS
  In a multicenter study in six Dutch hospitals, data were extracted from medical records of 380 outpatients with cancer. Data of the first three visits at the outpatient clinic were studied. Descriptive statistics were conducted.
  
  
  RESULTS
  In 23% of all 987 visits at the outpatient clinic, pain or absence of pain was registered, and in an additional 15%, a nonspecific symptom description was given. Regarding all other visits, (62%) pain or absence of pain was not documented at all. Pain measurement using a VAS or NRS was documented in only one visit. Pain was more often registered in medical records of patients with metastasis, as well as in those of patients with urogenital tumors.
  
  
  CONCLUSIONS
  Pain in medical oncology outpatients is not systematically registered in their medical records. With one exception, pain was not registered with a VAS or NRS. Yet, registration and assessment of pain to monitor pain are essential to evaluate and adapt pain treatment over time. Pain registration has not improved since 2001 and therefore implementing the recommendations regarding systematic monitoring of pain is needed.
authors.affiliation: Anaesthesiology, Pain and Palliative Medicine Department, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, The Netherlands.
authors.forename: Nienke D
authors.initials: ND
authors.lastname: te Boveldt
authors.forename: Myrra J F J
authors.initials: MJ
authors.lastname: Vernooij-Dassen
authors.forename: Anne
authors.initials: A
authors.lastname: Jansen
authors.forename: Kris C P
authors.initials: KC
authors.lastname: Vissers
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D059408:Pain Management; D010147:Pain Measurement / Q000592:standards*; D012042:Registries / Q000592:standards*; D012189:Retrospective Studies; D064232:Visual Analog Scale; D055815:Young Adult
keywords: cancer; pain assessment; pain management; pain registration