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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Palliative Care 1/2014

Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

Zeitschrift:
BMC Palliative Care > Ausgabe 1/2014
Autoren:
Joachim Erlenwein, Almut Geyer, Julia Schlink, Frank Petzke, Friedemann Nauck, Bernd Alt-Epping
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JE, AG, and JS collected the data; JE, FP, BA-E, and FN conceived the study and participated in its design and coordination; JE, FP, and BA-E performed the statistical analysis; JE, AG, FP, and BA-E drafted the manuscript. All authors read and approved the final manuscript.

Abstract

Background

A minority of patients with incurable and advanced disease receive specialised palliative care. Specialised palliative care services that complement the care of difficult and complex cases ought to be integrated with services that deliver general care for most patients. A typical setting in which this integrative concept takes place is the hospital setting, where patients suffering from incurable and advanced disease are treated in many different departments.
The aim of the study is to investigate the profile and spectrum of a palliative care consultation service (PCCS) at a German university hospital with special reference to pain therapy.

Methods

We retrospectively analysed the PCCS documentation of three years.

Results

Most patients were referred from non-surgical departments, 72% were inpatients, and 28% were outpatients. 98% of the patients suffered from cancer. Counselling in pain therapy was one of the key aspects of the consultation: For 76% of all consulted patients, modifications of the analgesic regimen were recommended, which involved opioids in 96%. Recommendations on breakthrough-pain medication were made for 70% of the patients; this was an opioid in most cases (68%). The most commonly used opioid was morphine. For 17% of the patients, additional diagnostic procedures were recommended. Besides pain management palliative care consultation implied a wide range of recommendations and services: In addition to organising home care infrastructure, palliative care services supported patients and their families in understanding the life-limiting diseases. They also coordinated physical therapy and social and legal advice.

Conclusion

This survey clearly shows that for a consultation service to support patients with incurable or advanced disease, a multi-disciplinary approach is necessary to meet the complex requirements of a needs-adapted palliative care in inpatient or outpatient settings. Timely integration of palliative expertise may support symptom control and may give the required advice to patients, their carers, and their families.
Literatur
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