Prevalence of Pain. and analgesic therapy adequacy in patients hospitalized in a university hospital

Abstract

Objectives: To evaluate the prevalence of Pain. and adequacy of analgesic therapy administered to patients at a university hospital, as well to assess the agreement between the painful self-reporting and data from medical records regarding Pain. manifestation. Methods: Observational and cross-sectional study, from structured interviews with adult patients who expressed a complaint of Pain. up to 24 hours prior to hospital admission or at any time after admission to the Lauro Wanderley University Hospital (LWUH) interviews. Socio-demographic and clinical characteristics of patients, type of analgesics, treatment regimens, intensity and characteristics of Pain. were evaluated. The medical records of medication use were collected through the notes in the medical report and lists of prescriptions. Pain. was assessed by visual analogue scale (VAS ) and the Multidimensional Pain. Scale (EMADOR). To assess the adequacy of analgesia used the Index of Pain. Management (IMD). The Analgesic Ladder of the World Health Organization was used in evaluating requirements. Results: In the period of the study, 480 patients admitted up to 18 years or more wards for adults of the LWUH. Of these, 115 (24%) complained of Pain. and were included in the sample. The age of the 115 participants ranged from 18 to 90 years, with a mean of 48,7 (± 17,7). It was found that 60 (52,2 %) had severe Pain. and 39 ( 33,9% ) had moderate pain. The assessment of agreement between the painful self-reporting and data from medical records regarding Pain. showed that only 45 (39,1% ) and 42 ( 36,1 %) of the times of admission and in the hospital course respectively, were recorded information about pain. Concerning the adequacy of analgesic therapy, it was found negative IMD in 85 (82,6 % ) patients. There was inappropriate prescribing in 78,3% of patients. The use of monotherapy use of non-opioid analgesics (dipyrone / acetaminophen) and nonsteroidal anti-inflammatory drugs in 87,8 % of patients was predominant, while opiates were used in only 14,7% of patients. Conclusions: The initial assumptions of this research were partially supported. The prevalence of Pain. in hospitalized patients was not high as assumed, but the analgesic adequacy was unsatisfactory. Moreover, there was no agreement between self-reported Pain. and records data, indicating that doctors do not to ask about this symptom or register it in the records. It has been shown inadequate treatment regimens and the need for greater knowledge of the analgesics use in Pain. therapy in the LWUH