Assessment of initial differences between inpatient and outpatient patients receiving pain therapy in Germany: the KEDOQ-Pain quality assurance system

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Sarah Kuekenshoner K Böhme F Bosse H R Casser T Kohmann G Lindena B Nagel F Petzke M Pfingsten M Hüppe

Abstract

KEDOQ-Pain is a quality assurance system for documentation and quality management of pain therapy under different treatment settings initiated by the German Pain Society. We used KEDOQ-Pain data to describe initial differences in sociodemographic, pain-related and psychological factors between pain patients receiving pain therapy in inpatient or outpatient treatment settings.


Our data, collected by the German Pain Questionnaire (DSF), comprised information on pain patients receiving out- and inpatient therapy (n=4,705).  Statistical analysis was carried out by descriptive and comparative data analysis using uni- and multivariate statistical methods.


Patients receiving inpatient pain therapy were significantly older, more often female and had more often multiple pain localizations. They reported greater pain intensity, had a higher stage of pain chronification and higher pain-related disabilities. They showed higher levels of anxiety, depression and stress and had a lower quality of life. Significant group differences, however, had only small effect sizes. Even though multivariate analysis revealed most predictors of treatment in an inpatient setting to be significant, taken as a whole they explained less than 5% of the observed variance.


Criteria underlying the current practice of allocation of patients to inpatient or outpatient pain therapy remain unclear. Our analysis suggests that highly chronified pain will increasingly be the challenge of future pain management, requiring professional competence from a multidisciplinary specialist team.

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How to Cite
KUEKENSHONER, Sarah et al. Assessment of initial differences between inpatient and outpatient patients receiving pain therapy in Germany: the KEDOQ-Pain quality assurance system. Medical Research Archives, [S.l.], v. 6, n. 7, july 2018. ISSN 2375-1924. Available at: <https://journals.ke-i.org/index.php/mra/article/view/1798>. Date accessed: 16 dec. 2018. doi: https://doi.org/10.18103/mra.v6i7.1798.
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References

(1) Hampel P, Moergel MF. Schmerzchronifizierung
bei Rückenschmerzpatienten in der stationären Rehabilitation. Der Schmerz 2009; 23(2): 154-165. doi: 10.1007/s00482-008-0743-8.

(2) Lindena G, Gerbershagen HU, Zenz M et al. Organisierte Schmerztherapie im DRG-System. Der Schmerz. 2005; 19(1): 40-54. doi: 10.1007/s00482-004-0374-7.

(3) Michalski D, Hinz A. Schmerzchronifizierung bei ambulanten Rückenschmerzpatienten. Der Schmerz. 20(3): 198-209. doi: 10.1007/s00482-005-0433-8.

(4) Wurmthaler C, Gerbershagen HU, Dietz G et al. Schmerzchronifizierung und psychologische Merkmale - Die Beziehung zwischen Chronifizierungsstadien bei Schmerz und psychophysischem Befinden, Behinderung und familiären Merkmalen. Geshundheitspsych. 1996; 4(2):113-136.

(5) Nilges P, Essau C. Die Depressions-Angst-Stress-Skalen. Der Schmerz. 2015; 29(6):649–657. doi: 10.1007/s00482-015-0019-z.

(6) Pfingsten M, Nagel B, Emrich O et al. Handbuch zum Deutschen Schmerzfragebogen. 2006. Revised version 2015 Nagel B, Pfingsten M, Lindena G, Kohlmann T. Deutsche Schmerzgesellschaft, Berlin. http://www.dgss.org/fileadmin/pdf/pdf_2/DSF-Manual_2015.pdf. Accessed April, 2018.

(7) Casser HR, Hüppe M, Kohlmann T et al. Deutscher Schmerzfragebogen (DSF) und standardisierte Dokumentation mit KEDOQ-Schmerz. Der Schmerz. 2012; 26(2): 168-175. doi: 10.1007/s00482-011-1142-0.

(8) Gerbershagen HU. Das Mainzer Stadienkonzept des Schmerzes. In: Klinger D, et al (Hrsg). Antidepressiva als Analgetika. Arachne, Linz 71-95. 1996.

(9) Von Korff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain 1992; 50(2):133–149. doi:.10.1016/0304-3959(92)90154-4.

(10) Bullinger M, Kirchberger I. SF-36 Fragebogen zum Gesundheitszustand. Hogrefe, Göttingen. 1998.

(11) Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995; 33(3):335–43. doi: 10.1016/0005-7967(94)00075-U

(13) Herda CA, Scharfenstein A, Basler HD. Marburger Fragebogen zum habituellen Wohlbefinden. Universität Marburg, Marburg 1998.

(14) Cohen J. Statistical power analysis for the social sciences. Lawrance Erlbaum Association. Hillsdale 1998.

(15) Frettlöh J, Maier C, Gockel et al. Patientenkollektiv deutscher schmerztherapeutischer Einrichtungen. Der Schmerz. 2009; 23(6):576-591. doi:.10.1007/s00482-009-0836-z.

(16) Gerbershagen H U, Lindena G, Korb J et al. Gesundheitsbezogene Lebensqualität bei Patienten mit chronischen Schmerzen. Der Schmerz. 2002; 16(4):271-284. doi:10.1007/s00482-002-0164-z.

(17) Dietl M, Korczak D. Spezialisierte Schmerzversorgung in Deutschland. Der Schmerz. 2013; 27(2):123-128. doi:.10.1007/s00482-013-1302-5.

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