title: [Pain therapy in in-patients with cancer. Effects of a manual-based approach as guideline for pain-consulting service at a university hospital].
abstract: BACKGROUND
  Appropriate medication is an important and substantial part in the therapy of tumor-induced pain.
  
  
  OBJECTIVE
  The objective of this study was to investigate the efficiency of anaesthesiology-based consultant service characterizing the quality of this type of treatment in daily clinical practice of a university hospital, i. e., in the patient profile of a tertiary center (study design: systematic clinical, unicenter observational study reflecting clinical practice and study-based control of therapeutic care quality).
  
  
  METHODS
  In the course of consulting function with regard to pain care on the single wards a considerable portion of cancer patients are recieving drugs. For most patients such care comprises several consultations and subsequently initiated treatment modifications. The consulting function ends if the patients feel free of pain or report a substantial improvement. From 1/1/2010 to 12/31/2012 detailed information on the drug therapy applied prior to, during and after the consultation was prospectively documented.This data was retrospectively evaluated as "pre-vs.-post" comparison (Chi-squared test, Fisher's exact test and McNemar's test), in particular, focussing on the quality of pain medication using the WHO index as well as pain intensity obtained by means of the visual analogue scale (VAS).
  
  
  RESULTS
  In total, 375 in-patients were treated. The modified pain medication by the anesthesiological consultant service led to a significant increase (p < 0.001; Wilcoxon's test) in the mean WHO index from 6.37 (SD, 1.83) to 8.43 (SD, 1.47). Furthermore, a reduction of VAS from 5.00 (SD, 2.39) to 2.64 (SD, 1.64) was noted (p < 0.001; Wilcoxon's test).
  
  
  CONCLUSIONS
  The consequent application of established guidelines (according to WHO scheme) and the WHO index leads to a qualitative and measurable improvement of drug therapy for cancer-related pain.
authors.forename: M
authors.initials: M
authors.lastname: Brinkers
authors.forename: Gernot
authors.initials: G
authors.lastname: Pfau
authors.forename: A
authors.initials: A
authors.lastname: Lux
authors.forename: Giselher
authors.initials: G
authors.lastname: Pfau
authors.forename: C
authors.initials: C
authors.lastname: Schneemilch
authors.forename: F
authors.initials: F
authors.lastname: Meyer
authors.forename: S
authors.initials: S
authors.lastname: Grond
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000776:Anesthesiology; D003299:Cooperative Behavior; D004359:Drug Therapy, Combination; D005260:Female; D019983:Guideline Adherence; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D012017:Referral and Consultation; D012189:Retrospective Studies
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid