Effective Pain Management for Inpatients at Siriraj Hospital: A Retrospective Study
Wangnamthip, S.; Euasobhon, P.; Siriussawakul, A.; Jirachaipitak, S.; Laurujisawat, J.; Vimolwattanasarn, K.
Journal of the Medical Association of Thailand 99(5): 565-571
2016
ISSN/ISBN: 0125-2208 PMID: 27501612 Document Number: 16463
The prevalence of severe cancer and non-cancer pain among in patients has been reported at rates ranging from 15% to 36%. We examined the effectiveness of the pain management provided to inpatients by the Siriraj Pain Clinic. A retrospective chart review was conducted among inpatients who had consulted the clinic between January 2013 and December 2014. Patients with a numeric pain rating scale (NRS) 4 on the day of consultation, those discharged within seven days, and postoperative patients were excluded. Successful pain control was defined as NRS ≤ 4 within seven days of the initial consultation. We identified 352 eligible patients, of which 231 (65.4%) had cancer pain. Only 42.6% achieved successful pain control. An absence of psychological problems (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.1-4.2; p = 0.010); an initial NRS < 7 (OR 1.9, 95% CI 1.2-3.0; p = 0.008); the use of either a non-steroidal anti-inflammatory drugs (NSAIDs) or a Coxibs (OR 2.3, 95% CI 1.3-3.9; p = 0.017), and abdominal pain (OR 2.7, 95% CI 1.5-4.7; p =0.008) were factors associated with successful pain control. Adequate pain control was achieved in less than half of the inpatients in our institution. Psychological disturbance and severe pain predicted unsatisfactory pain control.
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