[Pain in the hospital: from prevalence to quality standards]

Abstract

Objectives: Pain diminishes the quality of life of patients and a high prevalence of pain calls into question the quality of health care being delivered. The present study analyzes the prevalence of pain in one hospital, by departments and by therapeutic approach used.

Patients and methods: This cross-sectional study was carried out in a representative sample of 309 patients admitted to a tertiary care hospital. Information was gathered by patient interviews and by reviewing hospital records for personal characteristics, clinical situation, pain characteristics and analgesic treatment.

Results: The prevalence of pain was 54.7% overall. The prevalence of pain eligible for treatment (intensity >2 on a visual analog scale) was 43.5%. The prevalence of pain that was moderate to intense (>3) was 34.7%. No analgesia was prescribed for 18.7% of the patients eligible, and analgesia was effective for 47.3%. Analgesia was provided on demand (63.2%) in most clinic protocols, usually with nonsteroidal antiinflammatory drugs, acetaminophen, opioids and special techniques, administered in combination to half the patients. The prevalence and intensity of pain and the prescription protocols varied from one hospital department to another. Analgesic treatment was adequate for 67.1% of the patients.

Conclusions: The results suggest that the prevalence of pain in the hospital is high and that it is possible to improve quality of clinical approach, in agreement with studies that have been appearing since the 1980s. The persistence of the problem of pain in health care centers requires action on all levels of the health care system.