Cross-sectional study on the current status of pain medical care provided by german specialized outpatient palliative care teams (SAPV)

Background: With the help of specialized outpatient palliative care teams (SAPV), seriously ill and dying patients in Germany can be adequately cared for in their home environment until the end of their lives. However, there are no uniform standards or guidelines for well executed pain therapy right now. Objectives: This approach serves as basic research in the field of public health research. This is intended to represent what methods (use of different professional groups, use of pain medications, alternative medical treatments etc.) the individual SAPV-teams use for pain therapy. From this can be deduced which procedures can be considered particularly effective. Material and methods: This cross-sectional study was conducted in May 2021. All German SAPV-teams (n = 307) listed on the homepage of the German Association for Palliative Medicine (DGP) were contacted by mail and invited to participate. A total of 175 teams (57%) responded to the request and were included in the evaluation. A descriptive data analysis was performed. Results: Pain therapy in the German outpatient care of palliative patients is based on several components. All common pain medications are used, but primarily metamizole (99.4%) as a non-opioid analgesic, morphine (98.3%) from the opiate series and pregabalin (96.6%) as a co-analgesic are mainly prescribed. If pain therapy fails, 22.5% of the SAPV-teams perform palliative sedation to archive symptom control on a regular basis. Conclusions: This cross-sectional study is the first of its kind to provide a general overview of the methods used for pain therapy in German outpatient palliative care. In comparison with international studies, the question arises as to whether uniform therapy schemes and a reduction in the medication available in the individual SAPV-teams could lead to an improvement in patient care.