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Out-patient chronic pain service in Hong
Kong: prospective study
PP Chen, J Chen, T Gin, M Ma, KC Fung, KH Woo, PY Wong
Division of Pain Medicine, Department of
Anaesthesia and Intensive Care, The
Chinese University of Hong Kong, Prince
of Wales Hospital, Shatin, Hong Kong
OBJECTIVE. To examine the profile and referral pattern of patients attending an
out-patient pain management service in Hong Kong.
DESIGN. Prospective cross-sectional survey.
SETTING. Regional public hospitals, Hong Kong.
PATIENTS. All patients attending out-patient pain management clinics in the New
Territories East public hospitals between 1 September and 31 December 2002.
MAIN OUTCOME MEASURES. Demographic profiles, referring
specialty, pain diagnosis, pain sites, duration and severity of
pain, treatment modality, litigation, compensation, and social welfare
status. Data were collected using a standardised
questionnaire.
RESULTS. Two hundred and forty-eight patients were
interviewed. Most patients (70%) were middle-aged, with 21% over
60 years. Seventy-nine percent of patients were referred to the
clinics either from orthopaedic surgeons (64.1%), general and other
surgeons (14.9%), or general practitioners (3.6%). The median (range)
duration of pain was 2.3 (0.08-26.7) years. The most common pain
diagnoses were musculoskeletal back pain (46.4%) and neuropathic
pain (27.8%). A total of 11.3% of the patients had two pain diagnoses,
while 40.7% complained of pain in more than one location. Pain in
the limbs was the most frequent complaint followed by the head,
neck, and back. Approximately 38% of patients had tried four or
more treatment modalities. Oral medication was the most common method
(86.7%) of pain-relief treatment. More than half of the patients
had also tried physiotherapy and traditional Chinese medicine. Approximately
37% of the patients were unemployed, while 31% were receiving social
security subsidy. Eighty-six patients had pain associated with a
work-related injury, and of these patients, 80% were involved in
compensation claims.
CONCLUSIONS. The profile of patients referred to
the pain management clinics was complex. Patients were mainly referred
from specialists. The economic implication in this group of patients
is likely to be significant as many patients utilised multiple treatment
modalities, were unemployed and on social welfare benefits, and
were involved in compensation and litigation proceedings.
Hong Kong Med J 2004;10:150-5
Key words: Health care surveys; Pain; Pain clinics
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