Table 3

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)
Variables Number Percentage Number Percentage p-value
Age
 Median (Range) 68 (22-94) 65 (41-82) 0.71
Gender
 Male 112 52.6 11 5.2 0.60
 Female 80 37.5 10 4.7
KPS
 Median (Range) 40 (10-80) 40 (10-80) 0.79
Primary cancer site
 Respiratory tract 29 13.5 3 1.4 0.98
 Gastrointestinal tract and liver/galbladder/pancreas 53 24.9 6 2.8
 Genitourinary 70 32.9 7 3.3
 Others 40 18.8 5 2.4
Treatment status at initial PCT consultation
 Chemotherapy/Radiotherapy/Surgery/Diagnosis 95 44.6 8 3.8 0.32
 Only symptom management 97 45.5 13 6.1
Purpose of admission
 Chemotherapy/Radiotherapy/Surgery/Diagnosis 77 35.7 10 4.7 0.48
 Only symptom management 115 54.4 11 5.2
Coexistence of delirium
 Yes 21 9.9 4 1.9 0.27
 No 171 80.2 17 8.0
Current opioid use at initial PCT consultation
 Yes 83 39.0 9 4.2 0.97
 No 109 51.1 12 5.7
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
 Others4) 20 9.4 0 0
Experience of primary physician
 < 6years 22 10.4 3 1.4 0.17
 6-10years 81 38.0 13 6.2
 > 10years 89 41.8 5 2.3

* p<0.05.

**p<0.01.

*** p<0.001.

†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

Open Data