• Aparna Chatterjee, Ganesh Nimje, and P N Jain.
• Aparna Chatterjee, MD, FCARCSI, Ganesh Nimje, MD, and P. N. Jain, MD, MNAMS, are with the Department of Anesthesia, Critical Care & Pain, Tata Memorial Centre, Homi Bhabha National Institute , Mumbai , India .
• J Pain Palliat Care Pharmacother. 2019 Mar 1; 33 (1-2): 6-14.

AbstractThe study aimed to identify patterns of patient referral from oncology services, including pain severity, prior analgesics, impact of patient's literacy on referral, and adequacy of pain relief offered by the pain clinic. A retrospective analysis of pain clinic data from August 2014 to February 2015 at the Tata Memorial Hospital was carried out, wherein adult cancer patients referred for the first time to the pain clinic were included. Two thousand patients were included: 38.1% of the referred were at pretreatment stage, 28.8% advanced. Most referrals were from head and neck (27.3%), gastrointestinal (26.2%), and thoracic (18.3%) disease management groups (DMGs); The earliest referrals were from gastrointestinal and thoracic DMGs; 75%-80% had advanced disease. There were few referrals from hemato-oncology and medical oncology. Among the patients, 88% had moderate to severe pain, a third were on analgesics, and less than a fifth were on opioids. Pain scores were lower in the literate group, and this group were referred significantly earlier than the illiterate. Literacy could therefore hold the key to better awareness and compliance with pain management. Our findings demonstrate that pain as yet does not receive a much needed priority even at a tertiary care cancer centre.

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