Inadequate treatment of pain in ambulatory HIV patients

Abstract

Objective: To evaluate the prevalence of pain, how pain affects patients' lives, what treatments are being used, and the effectiveness of these pain treatments in ambulatory patients with human immunodeficiency virus (HIV) disease.

Design: A self-administered pain survey (modified version of the Wisconsin Brief Pain Questionnaire).

Setting: An ambulatory infectious disease clinic that deals mainly with ambulatory HIV patients.

Patients: Ambulatory HIV patients.

Outcome measures: Results of the response to the questionnaire.

Results: Eighty-two of 148 patients surveyed had pain due to their disease in the month prior to completing the survey. Of those reporting pain, 60-70% reported that their pain interfered with aspects of their daily lives from a moderate to severe degree. In patients with pain, 40% reported that they were not receiving any pain treatment. Those patients who were receiving treatment only obtained a mean pain relief of 65%.

Conclusions: Pain is an important problem in terms of its prevalence and impact on patients with HIV disease. Pain control in this patient population is inadequate. Clinicians should realize that pain can be present regardless of the duration of the disease and its severity. Patients need to be educated about the proper use of pain medications and helped to understand that pain medications will not "worsen their disease."