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Pain in medical inpatients: an under-recognised problem?
1Centre for Inflammation Research, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK. mozza@doctors.org.uk.
The Journal of the Royal College of Physicians of Edinburgh
|December 15, 2010
Summary
Pain is common in general medical patients, with 53% experiencing it. Chronic pain significantly impacts inpatient pain and complicates analgesic management, highlighting a need for improved pain control strategies.
Area of Science:
- Internal Medicine
- Pain Management
Background:
- Pain is prevalent in various illnesses, yet its occurrence in general medical patients is understudied.
- While significant for surgical and terminally ill patients, evidence on general medical patient pain is limited.
Purpose of the Study:
- To determine the prevalence of pain in general medical inpatients.
- To assess the contribution of chronic pain to inpatient pain experiences.
- To evaluate analgesic prescription practices and efficacy.
Main Methods:
- A prospective study involving 156 general medical inpatients in a teaching hospital.
- Data collection via questionnaires on pain occurrence, severity, and analgesic use over three consecutive days.
- Review of patient analgesic prescriptions and contraindications.
Main Results:
- 53% of patients experienced pain, with 38% reporting severe pain (pain score >6).
- Chronic pain (37% of patients) was associated with increased inpatient pain severity.
- Non-recommended analgesic prescriptions were common (OR 12) and linked to pain occurrence; 18% had <50% analgesic efficacy.
Conclusions:
- Pain is highly prevalent in general medical patients, often exacerbated by pre-existing chronic pain.
- Current analgesic prescription practices are suboptimal, with frequent use of non-recommended medications and poor patient response.
- Significant improvements in pain management are needed for general medical patients, presenting a more complex challenge than in surgical settings.
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