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Palliative Medicine
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Provision for advanced pain management techniques in adult palliative care: a national survey of anaesthetic pain specialists

S. Kay

Myton Hospice, Warwick, UK

E. Husbands

Anaesthetic Department, Warwick Hospital, Lakin Road, Warwick, CV34 5BW, UK, hugh.antrobus{at}swh.nhs.uk

J.H. Antrobus

Warwick Hospital, Warwick, UK

D. Munday

Myton Hospice, Warwick, UK

Introduction : It is estimated that 8% of cancer patients could benefit from advanced pain management techniques; some 12 000 patients per year in the UK. In 2002, Linklater et al. surveyed palliative medicine consultants to assess their access and attitude to such techniques, finding under-utilization with a lack of formal arrangements for referral. We report a survey of pain specialist anaesthetists on the same topic. Method : Postal questionnaire survey of lead anaesthetists in UK pain clinics. Results : 106 responses were received from 170 questionnaires sent (62%). Referral rates from palliative medicine to pain clinics were low; only 31% of respondents received more than 12 per year. Joint consulting arrangements were rare, but were associated with more referrals. Only 25% of anaesthetists' job plans had time allocated for palliative medicine referrals, but where present this correlated positively with referrals received (P <0.002). Total interventions were estimated at less than 1000 per year. Discussion : There is evidence of under-referral of patients for advanced pain management procedures with a lack of integrated services. Palliative Medicine 2007; 21 : 279—284

Key Words: advanced pain management techniques • delivery of health care • pain clinics • palliative care • questionnaire survey

Palliative Medicine, Vol. 21, No. 4, 279-284 (2007)
DOI: 10.1177/0269216307078306
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