Computer system improves pain therapy for cancer patients

Heidelberg 11 August 2009Pain therapy for cancer patients - whether inpatient or outpatient - is often inadequate. At Heidelberg University Hospital, the use of an innovative electronic system - combined with guidance by an experienced clinical pharmacist - has been successfully tested. The treatment of the patients showed little variance from international guidelines on pain therapy. In addition, patients reported having less pain. The results of the study have been published in the journal Pain.


The electronic pain relief guide AiDPainCare is an additional instrument of the electronic pharmaceutical guide AiDKlinik, which guides physicians safely through the current pharmaceutical market in Germany with over 64.000 products and successfully helps avoid false dosages, side effects, dangerous drug interaction, and duplications in prescriptions. The medication prescribed by the physician can be transferred from AiDKlinik directly to a prescription or medical report. The system is currently in use in 10 hospitals in Germany and can also be subscribed to by physicians in private practice.

AiDKlinik was developed in 2003 by the Department of Internal Medicine VI, Clinical Pharmacology and Pharmaco-epidemiology, at Heidelberg University Hospital in conjunction with the hospital pharmacy. The Ministry of Education and Research funded development. Third party funding from the Ferdinand Heinrich Mörsel Foundation was acquired especially for the development of AiDPainCare.

"The safety of drug therapy from prescribing to administering is a central aspect of our work", explained Professor Walter E. Haefeli, Medical Director, Department of Internal Medicine VI, Clinical Pharmacology and Pharmaco-epidemiology. Their co-operation unit Clinical Pharmacy, led by Director, Dr. Thilo Bertsche, working with the Heidelberg Pain Center under the direction of Professor Hubert J. Bardenheuer, has processed the internationally established treatment guidelines in electronic form. The system was tested and successfully implemented for pain therapy of cancer patients on wards at Heidelberg University Hospital Department of Radio-oncology and Radiation Therapy, led by Medical Director, Professor Jürgen Debus.

In a pilot phase of the study, the researchers determined that in pain treatment begun outside the hospital, underdosing with morphine-based analgesics was common and so-called co-analgesics, e.g. antidepressants or cortisone products, were not used sufficiently. "Co-analgesics in particular can frequently improve pain therapy in patients, but are still being prescribed too rarely", stated Dr. Thilo Bertsche.

The use of AiDPainCare improved the competent prescribing of such co-analgesics and of opioid (opiate-based) pain medication to treat pain peaks and breakthrough pain. In this area especially, AiDPainCare was used to support physician's therapy for individual patients. In addition, the module provides quick access to general principles on treatment with opioids and legal information. This should reduce unfounded fears about prescribing a narcotic. Flyers designed especially for patients can also be printed.

After successful testing, AiDPainCare will be available on all computers at Heidelberg University Hospital shortly. This should make pain therapy in Heidelberg more effective and better tolerated and reduce patients' fears of pain in the hospital. Moreover, it is planned to offer the module to external users of AiDKlinik.

The paper titled "Multidisciplinary pain management based on computerized decision support in cancer pain patients" was written by T. Bertsche, V. Askoxylakis, G. Habl, F. Laidig, J. Kaltschmidt, S.P.W. Schmitt, H. Ghaderi, A. Zabel-du Bois, S. Milker-Zabel, J. Debus, H.J. Bardenheuer, and W.E. Haefeli. The study appeared in Pain 2009.

Internationally recognized patient care, research, and teaching Heidelberg University Hospital is one of the largest and most prestigious medical centres in Germany. The Medical Faculty of Heidelberg University belongs to the internationally most renowned biomedical research institutions in Europe. Both institutions have the common goal of developing new therapies and implementing them rapidly for patients. With about 7000 employees, training and qualification is an important issue. Every year, around 500.000 patients are treated on an inpatient or outpatient basis in more than 40 clinics and departments with 1600 beds. Currently, about 3100 future physicians are studying in Heidelberg; the reform Heidelberg Curriculum Medicinale (HeiCuMed) is one of the top medical training programmes in Germany.

Source: University Hospital Heidelberg

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