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Assessment of pain management adequacy among hospitalized pediatric patients: institutional-based cross-sectional
Asmamaw Emagn Kasahun1, Ashenafi Kibret Sendekie2, Rahel Belete Abebe2
1Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, University of Gondar, Gondar, Ethiopia.
Insights
Most hospitalized children receive inadequate pain medication, with pain management not matching severity. This highlights a critical gap in pediatric pain care, necessitating improved treatment protocols for better patient outcomes.
Area of Science:
- Pediatric Medicine
- Pain Management
- Healthcare Quality
Background:
- Pediatric pain is often inadequately assessed and treated, despite its significant impact on children.
- There is a lack of evidence regarding the adequacy of pain treatment in study settings.
Purpose of the Study:
- To assess the adequacy of pain management among hospitalized pediatric patients.
- The study was conducted at the University of Gondar Comprehensive Specialized Hospital in Ethiopia.
Main Methods:
- An institution-based cross-sectional study was conducted between June and August 2021.
- Data were collected via questionnaires and medical record reviews, with pain management adequacy assessed using the Pain Management Index (PMI) score.
- Logistic regression analysis was employed to identify predictors of inadequate pain management.
Main Results:
- Out of 422 pediatric patients, 63.3% received inadequate analgesics, and pain medication did not match pain severity.
- Younger children (under 1 year) and those with severe or moderate pain were more likely to receive inadequate pain medication.
- Pain medication was prescribed to 62.8% of participants.
Conclusions:
- Pain management in hospitalized pediatric patients was largely inadequate and did not align with pain severity.
- Approximately two-thirds of pediatric patients received insufficient pain medication, indicating a failure in appropriate pain management.
- The findings underscore the need for improved pain management strategies in pediatric healthcare settings.
Background:
As the evidence showed, despite the magnitude of the effects that pain can have on a child, it is often inadequately assessed and treated. However, whether pain is adequately treated or not, evidence is lacking in the study setting.
Objectives:
This study assessed pain management adequacy among hospitalized pediatric patients at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.
Methods:
An institution-based cross-sectional study was conducted among pediatric patients admitted to the University of Gondar Comprehensive and Specialized Hospital between June and August 2021. Eligible patients were enrolled in the study using consecutive sampling techniques. Data were collected using a structured interview-based questionnaire and a review of the patient's medical records that were prepared after reviewing earlier studies. Pain management adequacy was determined using the pain management index (PMI) score. Statistical Software for Social Sciences (SPSS) version 22 was used for data entry and analysis. Descriptive statistics such as frequencies, percentages, and means with standard deviation were used to describe the respective variables. Logistic regression was used to assess predictor variables of pain management adequacy. A p-value <0.05 at a 95% CI was considered statistically significant.
Results:
Of the 422 participants enrolled in the study, most (58.1%) were males, with a mean age of 3.9 ± 0.8 years. Pain medication was prescribed to 62.8% (95% CI: 57.3-68.2) of the participants. About 63.3% (95% CI: 58.8%-68%) received inadequate analgesics. The type of painkillers administered also did not match the severity of the pain. Pediatric patients less than 1 month and between 1 month and 1 year (AOR = 2.891, 95% CI: 1.274-12.899 and AOR = 2.657, 95% CI: 1.350-5.175), respectively, and patients with severe and moderate levels of pain (AOR = 3.448, 95% CI: 1.902-6.251 and AOR = 5.345, 95% CI: 1.956-9.828), respectively, were found to have inadequate pain medication compared with their counterparts.
Conclusion:
This study revealed that pain was hardly managed based on its severity. Overall, two-thirds of pediatric patients received inadequate pain medication. This indicates majority of patients experienced pain did not manage appropriately.
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