|Characteristics of triads of patient-physician, by two categories of accurate pain assessment and under-diagnosis of pain by primary physicians|
|Coexisisting moderate or Severe pain6) (N = 213)|
|Accurate pain assessment (N = 192)||Under-diagnosis of pain by primary physicians (N = 21)|
|Median (Range)||68 (22-94)||65 (41-82)||0.71|
|Median (Range)||40 (10-80)||40 (10-80)||0.79|
|Primary cancer site|
|Gastrointestinal tract and liver/galbladder/pancreas||53||24.9||6||2.8|
|Treatment status at initial PCT consultation|
|Only symptom management||97||45.5||13||6.1|
|Purpose of admission|
|Only symptom management||115||54.4||11||5.2|
|Coexistence of delirium|
|Current opioid use at initial PCT consultation|
|Duration of hospitalization (Days)|
|Median (Range)||34 (2-394)||42 (8-293)||0.06|
|Interval between admission and initial PCT consultation (Days)|
|Median (Range)||4 (0-148)||25 (0-251)||< 0.0001**|
|Clinical department of primary physician|
|Internal medicine less-experienced oncology 1),5)||41||19.3||7||3.3||0.33|
|Internal medicine more-experienced oncology 2),5)||66||31.0||7||3.3|
|Surgery3) and Urology/Obstetrics and Gynecology||65||30.5||7||3.3|
|Experience of primary physician|
†Compared according to the two categories of pain assessment: accurate pain assessment and under-diagnosis of pain by primary physicians.
†Wilcoxon rank-sum test for age, KPS, duration of hospitalization, and interval between admission and initial consultation to PCT;χ² for gender, primarycancer site, tratment status at initial PCT consultation, purpose of admission, coexistence of delirium, current opioid use at initial PCT consultation, durationof hospitalization, interval between admission and initial PCT consultation, clinical departments of primary physician, and experience of primary physician.
1) General medicine, Internal medicine specialized Renal and Cardiovascular.
2) Internal medicine specialized Gastroenterological, Respiratory, Hematology, and Oncology.
3) Surgery specialized Upper and Lower gastroenterological, Hepato-Biliary-Pancreatic Surgery, Respiratory, Mammary gland, and Thyroid.
4) Orthopedic surgery, Otorhinolaryngology, Dermatology, and Oral surgery.
5) Less-experienced and more-experienced oncology was defined by cancer patient data from the hospital register.
6) We defined coexisting moderate or severe pain as intensity of pain was ≧ 4 on the Numerical Rating Scale (NRS) rated by patients, or ≧8 on the AbbeyPain Scale (APS) documented by palliative care physicians with the form for palliative care physicians at the initial consultation to a PCT.
PCT; Palliative Care Team.
KPS; Karnofsy Performance Stasus.
Akashi et al.
Akashi et al. BMC Palliative Care 2012 11:7 doi:10.1186/1472-684X-11-7