[Bremen-north working team on pain--an intervention to improve the quality of medical care in a city district as exemplified by pain therapy].

The purpose of an intervention in a city district of Bremen was to reduce the discrepancy between the possibilities and realities of pain therapy. All the important participants were included in measures and actions on several levels and for several target groups for a period of two years. An inquiry revealed a high degree of consent among the medical practitioners. The effect of the intervention was an improvement in the prescription of opioids by those physicians who had already been prescribing them, whereas there was no noticeable change in the behaviour of physicians who had not been prescribing opioids to date. In a second step the intervention was examined for reasons and limitations of its efficacy. In conclusion, this is brought in line with the present state of knowledge on the ways and mechanisms by which new medical advances come to the attention of medical practice. The elements of promising strategies to effect positive changes in health services are pinpointed.