Treatment of pain in German neurology: Structures and standards of evaluation

Nineteen university departments and 108 non-university departments of neuro logy participated in a survey on standards of evaluation of pain patients, equalling a response rate of 37%. Twentyone per cent of these departments r un a neurological outpatient pain clinic, 38% work in a multidisciplinary p ain clinic for outpatients and 88% treat inpatients suffering from pain. A standardised evaluation of somatic aspects of pain syndromes is effected in 22% of the departments, whereas psychic aspects are assessed in 15%. 24% o f the departments use them for follow-up assessments mostly via locally dev eloped questionnaires and scales. Twenty per cent of doctors consider their evaluation tools a relevant or considerable help in diagnosing pain syndro mes, 47% in the therapy of pain patients. Seventy per cent reported on a sa tisfactory balance between efforts and benefits of their evaluation instrum ents, while only 6% reported in a considerable benefit. This survey shows t hat general acceptance of standardised and validated instruments for the ev aluation of pain syndromes is low in German neurology. Hence, it appears ma ndatory to explore and emphasise scientifically the advantages of such inst ruments in daily practice via specific studies. In addition to the improvem ent in clincial care of pain patients, high-quality documentation is necess ary to meet the increasing demands by health policy makers and general publ ic with regard to the transparency of medical services and also in relation to the cost-utility analysis in this important sphere of clinical neurolog y.