The aim of the present study was to assess the relationship between late referral to a PCT after hospital admission and the under-diagnosis of pain by primary physicians

in Japan, which may help to identify the optimal time to consult with a PCT for pain assessment. Methods Study design, setting, and samples We retrospectively examined the relationship between the duration from admission to initial PCT consultation and under-diagnosis of pain by primary physicians. We reviewed Inhibitors,research,lifescience,medical the electronic medical records of 351 consecutive cancer inpatients who had been referred to the PCT between June 2009 and March 2011. Our study samples comprised triads of patients and their primary and palliative care physicians at the initial PCT Inhibitors,research,lifescience,medical consultation. The present study was conducted according to the principles of the Declaration of Helsinki. The study protocol was reviewed and approved by the Institutional Review Board and the Ethics Committees of Teikyo University. Setting We conducted this study at Teikyo University Hospital, in Japan, which is a teaching-hospital with 24 medical departments and 1154 beds, providing general acute care. The Department of Palliative Care at the hospital has provided PCT services since April 2009. Patients We retrieved data from all consecut Inhibitors,research,lifescience,medical ive cancer inpatients over 18years of age and with moderate to severe pain who

were referred to the PCT of the hospital by their primary

physicians during a 20-month period. Patients who were referred to the PCT on two or more occasions, and those Inhibitors,research,lifescience,medical without moderate or severe pain were beyond the scope of this study and were LY2835219 excluded from the study. We defined coexisting moderate or severe pain as that rated by patients at an intensity of pain was either≥4 on the Numerical Rating Scale (NRS), or≥8 on the Abbey Pain Scale (APS), documented by palliative care physicians [15,16]. Physicians All primary physicians (full-time employed, including residents) who referred a selected patient to the PCT were Inhibitors,research,lifescience,medical included in the study. The PCT comprised three palliative care physicians, one psycho-oncology physician, and two nurse practitioners. The service provided many by the PCT was primarily consultative and was available to all inpatients upon request by a patient’s primary physician. The PCT conducted daily rounds and participated in decision-making for the treatment program, critical care, nursing, respiratory therapy, and nutritional service. At the initial PCT consultation, the palliative care physicians assessed the referred patients, proposed problems, and organized possible solutions. Outcome: under-diagnosis of pain by primary physicians Primary and palliative care physicians independently recorded each patient’s problems using the same standardized checklist (i.e., coexisting pain: Yes or No) at the initial PCT consultation.