Introduction: Patients in the palliative phase of their illness suffer from a lot of symptoms. It is known that these symptoms are partly related to each other. As pain is a central symptom in palliative care the relationship of this symtom to other problems discussed in referrals to palliative care consultation teams (PCC) is of interest.
Methods: In the period March 2001-March 2003 all problems discussed in patient-related referrals (n=4109) to 19 Dutch PCCs were registered on standard forms. Pain was the most discussed problem, in 1763 (42.9%) of the referrals. These referrals were analysed with respect to pain related problems, which were divided into three categories: problems associated with 1) the patient, 2) the health care professionals and 3) the health care organisation. The percentage of problems within these categories were analysed, comparing all referrals to the percentage of only those referrals in which pain was considered a main problem.
Results: The main problems associated with the patient consisted of anxiety/ agitation (28.2 vs. 22.9% in all patient-related referrals), constipation (20.9 vs. 13.7%) and nausea (20.5 vs. 14.5%). The professional associated problems were: choice, route and dosage of medication (24.5, 23.0 and 20.0%, respectively vs. 19.7, 16.2 and 14.2%, respectively). The problems related to the organisation of care consisted of use of material (12.2 vs. 10.4%), inventarisation of necessary care of the patient (11.5 vs 8.9%), and inventarisation of necessary home care (10.7 vs 10.5%).
Conclusion: If pain is discussed in referrals to PCC teams, other symptoms such as anxiety/agitation, constipation and nausea are more prevalent. Beside this, more support is asked related to medication subscription and the organisation of care. The results of this study show the need for training and support of health care professionals caring for palliative patients in pain.