798 introducing an electronic patient record in a multidisciplinary pain clinic

1
Poster Sessions / European Journal of Pain 13 (2009) S55S285 S229 countries: Turkey (ranked 9 th ), China (12 th ), Brazil (15 th ) and South Korea (18 th ). The geographical analysis reveals: (a) continuous decline of North America’s publication share from 46% in 1987 to 38% in 2007; (b) rising importance of the European share to over 46% in 2007, accompanied by an increasing prevalence of the European Union; (c) emergence of the Asian countries for a nearly 20% share of publications in 2007 largely from Japan, China, Taiwan and South Korea; (d) negligible presence of Africa (<2%) and (e) slow growth of South America from <1% in 1977 to <3% in 2007. Conclusion: The rapid evolution and explosion of pain research in the last 30+ years was accompanied by important changes in the landscape of the contributing countries and geographical regions. 797 AN IMPROVED SYMPTOM AND SIDE-EFFECT EVALUATION TOOL USED IN CHRONIC NON-CANCER PAIN PATIENTS T. Jonsson 1 *, M.K. Brøns 2 , N. Medin 2 , J. Højsted 3 , P. Sjøgren 3 , L.L. Christrup 2 . 1 Multidisciplinary Pain Centre, Koege University Hospital, Koege, Denmark; 2 Department of Pharmacology and Pharmacotherapy, University of Copenhagen, Copenhagen, Denmark; 3 Multidisciplinary Pain Centre,Copenhagen University Hospital, Copenhagen, Denmark Background and Aims: The aim of this study was to further develop, test and validate a questionnaire to record/register symptoms and side-effects in chronic non-cancer pain patients. It was investigated if pain intensity, symptom prevalence, level of discomfort due to symptoms, side-effect prevalence and acceptance of side-effects had impact on health related quality of life and if high levels of pain relief affect the willingness to accept side-effects. Methods: Patients and a group of sex- and age-matched controls were asked to report their symptoms on a 43-item symptom checklist. Additionally, the patients were asked to evaluate if the reported symptoms were disease related or due to side-effects induced by their analgesics. Health related quality of life was assessed by SF-36 in both groups. Results: A total of 67 patients and 64 controls participated in the study. The numbers of symptoms reported by the patients (12.3) were significantly higher than those reported by the controls (6.8) (p < 0.001) The six most frequently symptoms reported by the patients were: Fatigue (73%); Memory deficits (61%); Constipation (55%) Concentration deficits (55%); Sweating (53%) and Dry mouth (52%) Conclusion: A difference was found in the level of reliability of the test between persistent and fluctuating symptoms. Symptom prevalence, level pain intensity, and discomfort due to symptoms had a negative impact on certain aspects of health-related quality of life, whilst acceptance of side-effects did not. Achieved pain relief had impact on the willingness to accept side-effects. Key-words: Analgesics; chronic pain; symptoms; side-effects 798 INTRODUCING AN ELECTRONIC PATIENT RECORD IN A MULTIDISCIPLINARY PAIN CLINIC A. Ljutow*, W. Schleinzer. Swiss Paraplegic Centre Institute for Anaesthesiology and Pain Medicine, Nottwil, Switzerland Background and Aims: Electronic patient records are more or less common in todays clinical practice. Multidisciplinary pain treatment has special needs to be fulfilled. Different medical specialities produce different data, which have to be recorded. Also, the aspect of quality management is crucial. Creating a database for scientific work is a necessity. Methods: We describe the conceptual work done to establish an electronic patient record for our pain clinic, which comprises anaesthesiologists, neurologists, orthopedics, psychologists, neuropsychologists, physiotherapists, neurosurgeons, psychiatrists and covers all methods from conservative, invasive and operative treatment options. Results: Screenshots of the actual patient data and its function are described, such as workflow, documentation of interventions, interdisciplinary patient management and quality management aspects. Conclusions: To handle about 30,000 patient treatments a year effectively and keep the information about the patients always and for all available the use of an electronic patient record, which fulfills the special needs of interdisciplinary pain treatment, is from the point of view of our daily work inevitable. 799 THE DN4 TEST TO ASSESS THE PREVALENCE OF NEUROPATHY IN TYPE 2 DIABETES PATIENTS AT THE GENERAL PRACTITIONER D. Bouhassira 1 *, B. Morlion 2 . 1 INSERM Ambroise Par´ e opital,Boulogne and Versailles Saint-Quetin University, Boulogne, France; 2 UZ Leuven , campus Pellenberg |, Pellenberg, Belgium Aims: The aims of this study were to evaluate neuropathy (NP) as well as to assess the prevalence of painful diabetic neuropathy (PDNP) in type 2 diabetes patients using the DN4 test, and to evaluate its usefulness and ease of use in primary care. Methods: A prospective cross-sectional multi-centre study with type 2 diabetes mellitus (T2DM) patients visiting their general practitioner (GP) was initiated at a large representative group of Belgian GPs (N = 270). Each GP was requested to enrol 10 consecutive patients. Demographics and medical history were recorded. The DN4 questionnaire, a 10-items clinician-administered diagnostic tool for NP was completed for all patients. A DN4 score of 4 positive items detects NP. The usefulness and ease of use of the test were investigated on a 10-point scale. Results: Data was collected from 1966 T2DM patients. Patients were on average 66.5 years old,were mainly female and were diagnosed with T2DM 9.05 years ago (± 7.5). Their mean (±SD) BMI was 29.96±5.40 kg/m 2 , HbA1c level 7.22±1.25. The average (±SD) DN4 score of all patients, was 2.15 ( ±2.46). One out of 4 patients included in this study (n = 499) had a positive DN4 test, indicating the presence of NP. The DN4 was perceived as a useful (7.43/10) and easy to use (7.63/10). Conclusions: In 25% of the T2DM patients consulting their GP, the presence of NP was detected with the assistance of the DN4 questionnaire. The DN4 test was perceived as useful and easy to use by the GP. With support from Pfizer Belgium 800 PAIN: THE IMPACT OF THIS PHENOMENON ON PUBLIC HEALTH A.M. Calil 1 , C.A.M. Pimenta 2 *, S. Rasslan 1 , T. Cunha Rana 1 . 1 Faculdade de Medicina da Universidade de S˜ ao Paulo, S˜ ao Paulo, Brazil; 2 Escola de Enfermagem da USP, S˜ ao Paulo, Brazil This study identified the prevalence of pain in a population that spontaneously sought for a screening emergency service in a general governmental hospital in the city of S˜ ao Paulo. It is a descriptive, exploratory study, which, using a quantitative approach, analyzed 2400 screening files of patients who were seen at the hospital in a 10-month period in 2008. Of the total, 1444 (60.0%) presented pain associated with some other complaint, which, in 396 (16.5%) of the cases was the main reason for their seeking the health service. Among the patients with pain, the main complaint was rheumatic diseases, headaches, orthopedic problems, and diabetes mellitus. There was a statistical association between the pre- existing disease and having pain. Pain is a phenomenon common to emergency services and it has a strong impact on chronic processes. Hopefully these findings will contribute with the health teams in evaluating, preventing, and treating painful situations prevailing in our environment.

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Page 1: 798 INTRODUCING AN ELECTRONIC PATIENT RECORD IN A MULTIDISCIPLINARY PAIN CLINIC

Poster Sessions / European Journal of Pain 13 (2009) S55–S285 S229

countries: Turkey (ranked 9th), China (12th), Brazil (15th) and South

Korea (18th). The geographical analysis reveals: (a) continuous

decline of North America’s publication share from 46% in 1987

to 38% in 2007; (b) rising importance of the European share to

over 46% in 2007, accompanied by an increasing prevalence of the

European Union; (c) emergence of the Asian countries for a nearly

20% share of publications in 2007 largely from Japan, China, Taiwan

and South Korea; (d) negligible presence of Africa (<2%) and (e) slow

growth of South America from <1% in 1977 to <3% in 2007.

Conclusion: The rapid evolution and explosion of pain research in

the last 30+ years was accompanied by important changes in the

landscape of the contributing countries and geographical regions.

797

AN IMPROVED SYMPTOM AND SIDE-EFFECT EVALUATION TOOL

USED IN CHRONIC NON-CANCER PAIN PATIENTS

T. Jonsson1 *, M.K. Brøns2, N. Medin2, J. Højsted3, P. Sjøgren3,

L.L. Christrup2. 1Multidisciplinary Pain Centre, Koege University

Hospital, Koege, Denmark; 2Department of Pharmacology and

Pharmacotherapy, University of Copenhagen, Copenhagen, Denmark;3Multidisciplinary Pain Centre,Copenhagen University Hospital,

Copenhagen, Denmark

Background and Aims: The aim of this study was to further

develop, test and validate a questionnaire to record/register

symptoms and side-effects in chronic non-cancer pain patients.

It was investigated if pain intensity, symptom prevalence, level of

discomfort due to symptoms, side-effect prevalence and acceptance

of side-effects had impact on health related quality of life and if high

levels of pain relief affect the willingness to accept side-effects.

Methods: Patients and a group of sex- and age-matched controls

were asked to report their symptoms on a 43-item symptom

checklist. Additionally, the patients were asked to evaluate if the

reported symptoms were disease related or due to side-effects

induced by their analgesics. Health related quality of life was

assessed by SF-36 in both groups.

Results: A total of 67 patients and 64 controls participated in

the study. The numbers of symptoms reported by the patients

(12.3) were significantly higher than those reported by the controls

(6.8) (p < 0.001) The six most frequently symptoms reported by the

patients were: Fatigue (73%); Memory deficits (61%); Constipation

(55%) Concentration deficits (55%); Sweating (53%) and Dry mouth

(52%)

Conclusion: A difference was found in the level of reliability of

the test between persistent and fluctuating symptoms. Symptom

prevalence, level pain intensity, and discomfort due to symptoms

had a negative impact on certain aspects of health-related quality

of life, whilst acceptance of side-effects did not. Achieved pain relief

had impact on the willingness to accept side-effects.

Key-words: Analgesics; chronic pain; symptoms; side-effects

798

INTRODUCING AN ELECTRONIC PATIENT RECORD IN A

MULTIDISCIPLINARY PAIN CLINIC

A. Ljutow*, W. Schleinzer. Swiss Paraplegic Centre Institute for

Anaesthesiology and Pain Medicine, Nottwil, Switzerland

Background and Aims: Electronic patient records are more or

less common in todays clinical practice. Multidisciplinary pain

treatment has special needs to be fulfilled. Different medical

specialities produce different data, which have to be recorded. Also,

the aspect of quality management is crucial. Creating a database

for scientific work is a necessity.

Methods: We describe the conceptual work done to

establish an electronic patient record for our pain clinic,

which comprises anaesthesiologists, neurologists, orthopedics,

psychologists, neuropsychologists, physiotherapists, neurosurgeons,

psychiatrists and covers all methods from conservative, invasive and

operative treatment options.

Results: Screenshots of the actual patient data and its function

are described, such as workflow, documentation of interventions,

interdisciplinary patient management and quality management

aspects.

Conclusions: To handle about 30,000 patient treatments a year

effectively and keep the information about the patients always and

for all available the use of an electronic patient record, which fulfills

the special needs of interdisciplinary pain treatment, is from the

point of view of our daily work inevitable.

799

THE DN4 TEST TO ASSESS THE PREVALENCE OF NEUROPATHY IN

TYPE 2 DIABETES PATIENTS AT THE GENERAL PRACTITIONER

D. Bouhassira1 *, B. Morlion2. 1INSERM Ambroise Pare

Hopital,Boulogne and Versailles Saint-Quetin University, Boulogne,

France; 2UZ Leuven , campus Pellenberg |, Pellenberg, Belgium

Aims: The aims of this study were to evaluate neuropathy (NP)

as well as to assess the prevalence of painful diabetic neuropathy

(PDNP) in type 2 diabetes patients using the DN4 test, and to

evaluate its usefulness and ease of use in primary care.

Methods: A prospective cross-sectional multi-centre study with

type 2 diabetes mellitus (T2DM) patients visiting their general

practitioner (GP) was initiated at a large representative group

of Belgian GPs (N=270). Each GP was requested to enrol 10

consecutive patients. Demographics and medical history were

recorded. The DN4 questionnaire, a 10-items clinician-administered

diagnostic tool for NP was completed for all patients. A DN4 score

of 4 positive items detects NP. The usefulness and ease of use of

the test were investigated on a 10-point scale.

Results: Data was collected from 1966 T2DM patients. Patients were

on average 66.5 years old,were mainly female and were diagnosed

with T2DM 9.05 years ago (±7.5). Their mean (±SD) BMI was

29.96±5.40 kg/m2, HbA1c level 7.22±1.25. The average (±SD) DN4

score of all patients, was 2.15 ( ±2.46). One out of 4 patients

included in this study (n =499) had a positive DN4 test, indicating

the presence of NP. The DN4 was perceived as a useful (7.43/10)

and easy to use (7.63/10).

Conclusions: In 25% of the T2DM patients consulting their GP,

the presence of NP was detected with the assistance of the DN4

questionnaire. The DN4 test was perceived as useful and easy to

use by the GP.

With support from Pfizer Belgium

800

PAIN: THE IMPACT OF THIS PHENOMENON ON PUBLIC HEALTH

A.M. Calil1, C.A.M. Pimenta2 *, S. Rasslan1, T. Cunha Rana1.1Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo,

Brazil; 2Escola de Enfermagem da USP, Sao Paulo, Brazil

This study identified the prevalence of pain in a population that

spontaneously sought for a screening emergency service in a

general governmental hospital in the city of Sao Paulo. It is a

descriptive, exploratory study, which, using a quantitative approach,

analyzed 2400 screening files of patients who were seen at the

hospital in a 10-month period in 2008. Of the total, 1444 (60.0%)

presented pain associated with some other complaint, which, in 396

(16.5%) of the cases was the main reason for their seeking the health

service. Among the patients with pain, the main complaint was

rheumatic diseases, headaches, orthopedic problems, and diabetes

mellitus. There was a statistical association between the pre-

existing disease and having pain. Pain is a phenomenon common to

emergency services and it has a strong impact on chronic processes.

Hopefully these findings will contribute with the health teams in

evaluating, preventing, and treating painful situations prevailing in

our environment.