Pain prevalence study in a large Canadian teaching hospital. Round 2: lessons learned?

Pain prevalence is an important indicator of quality patient care, representing a basis upon which improvement efforts may be developed. Based on results of an original pain prevalence survey at our institution in 2006, a follow-up prevalence study was conducted in November 2007. Pain and its interference with patients' activities, patient satisfaction with pain management efforts, prescribing practice, and perceived barriers to pain control were all studied using a modified version of the American Pain Society Patient Outcomes Questionnaire. Methodologic objectives included improving the response rate from the earlier study and collecting additional demographic data. A 58% response rate was achieved. Pain prevalence at the time of the survey was 84%, and 25.8% of patients experienced severe pain, on average, over the previous 24 hours. Patients were generally quite satisfied with pain management efforts. Of particular interest were the prescribing practices. Only 50% of patients studied on the medical units had a PRN opioid order. These results reinforce those of our original prevalence study, specifically, that pain is not well controlled at our institution.