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

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.