Abstract
An outreach fly-in fly-out rehabilitation medicine service has been established at a regional centre in south western, New South Wales, Australia to support local practitioners. This service includes an outpatient clinic, and an inpatients case conference and consultations. This study examined new referrals to the regional rehabilitation clinic over a 12 month period. There were 94 new patients with the median age of 57.5 years. The main reason for referral was noncancer pain assessment and management (60 patients, 63.8%); followed by post hospital discharge follow up (26 patients, 27.7%). The majority of patients with pain were already on opioid therapy at the time of initial consultation. 18 patients were found to be on a high dose of opioids (>100 mg/day of oral morphine or equivalent) with no recent pain specialist input. Risks of opioid related problems were assessed and identified in those patients with a high dose of opioid therapy. Reasons and barriers influencing opioid therapy for non-cancer chronic pain in the regional area are discussed. Further study is required to establish specialist rehabilitation medicine needs from local general practitioners perspective in regional areas.
Highlights
Health services in rural and remote areas in Australia are different from the ones in urban areas
3 patients out of 18 patients were reviewed by pain specialists in the past, none of these patients were regularly monitored by the pain specialists at the time of the initial assessment in the rehabilitation clinic
This study showed that chronic non-cancer pain was the most common reason for referrals to the regional rehabilitation clinic in Griffith
Summary
Health services in rural and remote areas in Australia are different from the ones in urban areas. People living in outer regional and remote areas seem to require travelling further and waiting longer to access primary care or local hospital services [1]. The outreach rehabilitation service includes an outpatient clinic, inpatient consultations and an inpatients/outpatients case conference. The GBH has a role in providing a hub for health care services for surrounds (ie, Remote Australia).
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