Abstract
Aims: The objective of this study was to describe the set-up of the chronic pain consultation service (CPS) in a tertiary care university hospital and to analyse a full year of its practice.
Methods: The CPS was administered by the Helsinki University Hospital Pain Clinic and was provided by a senior anaesthesiologist specialised in pain management. During the first year, 266 patients were seen and the medical records of 212 patients were analysed retrospectively. Information was collected about the requesting units, and types, duration, anatomical regions, intensity, mechanisms and treatments of pains of the patients, and the work-load expended for the consultations.
Results: The reasons for consultations were cancer (37% of patients), chronic non-cancer (27%) and acute pain (20%). The most common pain mechanism was nociceptive. The number of consultations per patient varied from 1 to 32. Most (56%) of those patients with more than four visits had invasive treatments. The median total time for the consultations per patient was 40 min. Strong opioids were administered for 60%, invasive treatments for 16%, psychological support for 5% and physiotherapy for 3% of the patients. The most commonly used opioids were controlled-release oral oxycodone and transdermal fentanyl.
Conclusions: A full-time pain specialist is mandatory for a functional CPS. Although the CPS was anaesthesiology-based, invasive treatments were ordered only for a few patients. It is recommended that hospitals should provide a constant consultation service for chronic pain patients.