Outpatient management of chronic pain in Middle Franconia

In Middle Franconia, one of the larger Bavarian administrative division (population 1994: 1,657,101), the number of patients suffering from cancer pain, chronic headache and chronic back pain is not known. Furthermore, there are no data on interdisciplinary organization of outpatient pain management. All physicians and psychologists involved in outpatient pain management in Middle Franconia (n=2130) were asked (questionnaires) to estimate the number of patients suffering from cancer pain, chronic (>6 months) headache and chronic (>6 months) back pain treated the last 12 months. 264 (12.4%) responses were analyzed; 107,346 patients had been treated in the last 12 months, 67% by a single specialist and 33% by two or more specialists. The participation of psychotherapists and anesthetists in outpatient management of pain patients was poor; 22,754 (21%) patients were thought to need multidisciplinary analgesia therapy in a pain clinic, which actually does not exist in Middle Franconia. The data presented suggest that patients suffering from chronic pain are not optimally managed in Middle Franconia. Regional institutions for multidisciplinary pain treatment have to be established close to where chronic pain patients live.