title: Characteristics and outcomes of chronic pain patients referred to hospital pain clinics: a prospective observational study.
abstract: BACKGROUND
  Understanding the patient referral patterns and medical profiles of patients attending hospital pain clinics, and the therapies offered to them, can provide a useful starting point for evaluating their effectiveness and identifying areas for improvement.
  
  
  METHODS
  A prospective observational study was carried out. Sociodemographic and clinical data were gathered at twelve centres. The diagnoses and pain treatments provided by the referring doctors were compared with the ones provided by pain clinicians. Pain severity and patients' quality of life were measured prospectively. Descriptive statistics were compared.
  
  
  RESULTS
  Two-hundred sixty-nine patients referred to 12 outpatient hospital pain clinics in Catalonia were followed for 3 months. Most were referred by orthopaedists (50.0%) or primary care physicians (20.2%). The mean age and time since pain onset were 59.4 and 4.1 years, respectively. Pain clinicians changed the diagnostic labels of 48.5% of the patients. Nearly all patients (89.2%) were receiving pain medications prior to referral. Treatment was modified in 94.8%. Pain clinicians used more interventional and/or alternative therapies (65.1% of patients), opioids (46.8%) and co-adjuvants (38.2%). Three months after referral, the 24-h worst and current pain severity had decreased by 30.9% and 27.8% on average, respectively. The mean (effect size) improvements in a quality of life (the EuroQol 5 Dimensions index) and pain (visual analogue scale) scores were, respectively, 0.16 (0.73) and 6.7 (0.31).
  
  
  CONCLUSIONS
  Pain clinicians refined the diagnoses and treatments of patients referred to hospital pain clinics and improved outcomes. Relatively few patients are referred from primary care considering the prevalence of chronic pain in this setting.
authors.affiliation: Department of Experimental and Health Sciences, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain - sebastia.videla@upf.edu.
authors.forename: Sebastián
authors.initials: S
authors.lastname: Videla
authors.affiliation: Pain Unit, Hospital de la Santa Créu i Sant Pau, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Català
authors.affiliation: Pain Unit, Hospital Vall d'Hebrón, Barcelona, Spain.
authors.forename: María V
authors.initials: MV
authors.lastname: Ribera
authors.affiliation: Pain Unit, Hospital del Mar, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Montes
authors.affiliation: Pain Unit, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Samper
authors.affiliation: Pain Unit, Pius Hospital, Valls, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Fuentes
authors.affiliation: Pain Unit, Hospital Clínic, Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Busquets
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010146:Pain / Q000188:drug therapy; D018710:Pain Clinics / Q000706:statistics & numerical data*; D059408:Pain Management; D010147:Pain Measurement; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid