An examination of the prevalence of acute pain for hospitalised adult patients: a systematic review

Abstract

Aims and objective: Aims of the review were to establish the prevalence of acute pain for adults in hospital, to identify the amount of severe or unacceptable pain reported and to examine the prevalence of acute pain within medical units.

Background: Acute Pain Services have been established in the United Kingdom (UK) to improve pain management within surgical settings. Acute pain is a common symptom across all hospital settings. However, medical settings have traditionally been considered low risk for acute pain and have therefore not always been included in the provision provided by APS. As a result 82% of APS surveyed in the UK felt that pain management was suboptimal on medical units.

Design and method: This review follows the process of a systematic review.

Results: Hospital-wide pain prevalence obtained ranged from 37·7-84%, severe pain prevalence ranged from 9-36%. The papers reviewed were of variable quality and heterogeneous resulting in the wide range of pain prevalence. Higher prevalence of pain was found for surgical patients compared to medical patients, although up to 55% of medical patients' reported pain.

Conclusion: It is difficult to determine a definite prevalence of pain for adults in hospital due to the variability of the studies examined. However, pain does remain a significant symptom with up to 35% of patients reporting severe pain and approximately 50% of medical patient reported pain.

Relevance to clinical practice: Awareness of the extent of pain as a problem for patients is the first step to improving practice. This review has demonstrated that there is a need for similar Acute Pain Teams and services for the staff and patients admitted to all areas of the hospital, including medical units to help clinicians assess and treat pain in all areas of a hospital setting.

Keywords: acute pain; hospital; medical units; pain prevalence; review; survey.