[Characteristics of pain and its treatment in patients at a nursing home]

Pain is an unique symptom which may constitute minor ailment but also the main complaint of a severe disease. It is one of the main factors that limits quality of life in patients with chronic diseases, specially in those institutionalized in nursing homes (NH). The aim of our study was to determine the characteristics of pain complaints and analgesic treatment, as well as the satisfaction degree of patients with their treatment. To this goal, an observational cross-sectional drug utilization study was undertaken in a sample of 74 patients of a nursing home. All of them were consuming analgesic drugs at the moment of the study and their mean (+/-standard deviation) was 75.5 +/- 13.9 years. The study analyzed several pain characteristics (intensity, etiology, localization and duration) as well as analgesic treatment features (drug, route of administration, prescribed dose and therapeutic compliance). The satisfaction with the therapeutic regimen was also evaluated. Nearly a third (32.4%) of patients described that they suffered severe pain, mostly from peripheral joints (70.1%) and mainly located in legs. The duration of pain was longer than one month in 56.8%. Most of patients were following a chronic treatment with scheduled analgesics, being paracetamol (28.7%) the most consumed drug. However, daily doses were less than considered effective to treat pain. The preferred route of administration was oral. The satisfaction degree varied nong the units of NH, but it was scored as acceptable in most patients. It may be concluded that pain is a highly prevalent issue in NH and, in spite of the provided analgesic treatment, was evaluated as severe by a significant group of patients. Although drugs were prescribed at "by the clock" patterns, the daily dose was below the recommended one. In spite of high prevalence of severe pain, patients were satisfied with the analgesic treatment they were receiving.