Multidisciplinary treatment of chronic pain in the German federal state of Northrhine-Westphalia

BACKGROUND: Multidisciplinary treatment of patients with chronic pain in pain centers was studied. The conditions of all multidisciplinary pain centers in the German federal state of Northrhine-Westphalia (NRW), an area of about 17 million inhabitants, were investigated. METHODS: The study included data from the index of all registered multidisciplinary pain centers in the years 1992, 1994, 1996, and empirical data of a written (questionnaire) in 1993 from physicians and psychologists working as specialists in the pain centers studied. RESULTS: Several new pain centers (inpatient wards, outpatient pain clinics) had been built up in the last years in Northrhine-Westphalia. The pain centers are organized mostly as outpatients' departments. Departments of psychological treatment of chronic pain are usually integrated into pain clinics. In recent years, the use of qualified psychological pain treatment by psychologists has been under-represented. Pain treatment evaluation is carried out by considering the structure of supply in pain management, the qualification and specialization of physicians and psychologists and the amount of treated patients with chronic pain. The 57 pain centers in the investigated area reported on about 120,000 patients with chronic pain a year, who were treated in multidisciplinary pain centers. The estimated number of patients with chronic pain in Northrhine-Westphalia was approximately 850,000 patients (4 million in Germany). CONCLUSIONS: There is an existing network of multidisciplinary pain centers in Northrhine-Westphalia. If we consider the estimated number of 850,000 patients with chronic pain in this area, the low number of yearly treated patients (120,000) indicates, that the capacity of multidisciplinary pain centers is inadequate for the demand of multidisciplinary treatment of patients with chronic pain in Northrhine-Westphalia.