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. 2024 Jul 15;23(1):171.
doi: 10.1186/s12904-024-01497-1.

Pain prevalence and pain relief in end-of-life care - a national registry study

Christel Hedman  1   2   3 , Per Fürst  4   5 , Peter Strang  4   6 , Maria E C Schelin  7 , Staffan Lundström  4   6 , Lisa Martinsson  8
Affiliations

Pain prevalence and pain relief in end-of-life care - a national registry study

Christel Hedman et al. BMC Palliat Care. .

Abstract

Background: Despite pain control being a top priority in end-of-life care, pain continues to be a troublesome symptom and comprehensive data on pain prevalence and pain relief in patients with different diagnoses are scarce.

Methods: The Swedish Register of Palliative Care (SRPC) was used to retrieve data from 2011 to 2022 about pain during the last week of life. Data were collected regarding occurrence of pain, whether pain was relieved and occurrence of severe pain, to examine if pain differed between patients with cancer, heart failure, chronic obstructive pulmonary disease (COPD) and dementia. Binary logistic regression models adjusted for sex and age were used.

Results: A total of 315 000 patients were included in the study. Pain during the last week of life was more commonly seen in cancer (81%) than in dementia (69%), heart failure (68%) or COPD (57%), also when controlled for age and sex, p < 0.001. Severe forms of pain were registered in 35% in patients with cancer, and in 17-21% in non-cancer patients. Complete pain relief (regardless of pain intensity) was achieved in 73-87% of those who experienced pain, depending on diagnosis. The proportion of patients with complete or partial pain relief was 99.8% for the whole group.

Conclusions: The occurrence of pain, including severe pain, was less common in patients with heart failure, COPD or dementia, compared to patients with cancer. Compared with cancer, pain was more often fully relieved for patients with dementia, but less often in heart failure and COPD. As severe pain was seen in about a third of the cancer patients, the study still underlines the need for better pain management in the imminently dying.

Trial registration: No trial registration was made as all patients were deceased and all data were retrieved from The Swedish Register of Palliative Care database.

Keywords: COPD; Cancer; Dementia; End-of-life care; Hearth failure; Pain; Palliative care; Symptom management.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Description of which persons were included in the study
See this image and copyright information in PMC

References

    1. Krikorian A, Maldonado C, Pastrana T. Patient’s perspectives on the notion of a good death: a systematic review of the literature. J Pain Symptom Manag. 2020;59(1):152–64. doi: 10.1016/j.jpainsymman.2019.07.033. - DOI - PubMed
    1. Meier EA, Gallegos JV, Thomas LP, Depp CA, Irwin SA, Jeste DV. Defining a good death (successful dying): Literature Review and a call for research and public dialogue. Am J Geriatr Psychiatry. 2016;24(4):261–71. doi: 10.1016/j.jagp.2016.01.135. - DOI - PMC - PubMed
    1. Abbott CH, Prigerson HG, Maciejewski PK. The influence of patients’ quality of life at the end of life on bereaved caregivers’ suicidal ideation. J Pain Symptom Manag. 2014;48(3):459–64. doi: 10.1016/j.jpainsymman.2013.09.011. - DOI - PMC - PubMed
    1. Henson LA, Maddocks M, Evans C, Davidson M, Hicks S, Higginson IJ. Palliative Care and the management of common distressing symptoms in Advanced Cancer: Pain, breathlessness, nausea and vomiting, and fatigue. J Clin Oncology: Official J Am Soc Clin Oncol. 2020;38(9):905–14. doi: 10.1200/JCO.19.00470. - DOI - PMC - PubMed
    1. Broese JM, de Heij AH, Janssen DJ, Skora JA, Kerstjens HA, Chavannes NH, et al. Effectiveness and implementation of palliative care interventions for patients with chronic obstructive pulmonary disease: a systematic review. Palliat Med. 2021;35(3):486–502. doi: 10.1177/0269216320981294. - DOI - PMC - PubMed

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