Pain relief in medical patients: does clinical judgment and prescribing knowledge suffice?

Scientific paper - Original scientific paper

• Title (croatian): Liječenje boli u internističkih bolesnika: da li su klinička procjena i znanje o propisivanju analgetika dovoljni?
• Author: Viktorija Erdeljić
• Author: Igor Francetić
• Author: Ksenija Makar-Aušperger
• Author: Robert Likić
• Author: Viola Macolić Šarinić
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

The aim of this study was to evaluate the quality of pain management in hospitalised patients. A cross-sectional study design that included all medical patients experiencing pain was used. Out of 167 patients hospitalized at the Department of Medicine at the University Hospital Zagreb, 41 patients were experiencing pain and 40 out of them received analgesics. Twenty-two out of 38 patients were treated for malignant pain, 16 for non-malignant pain, and 2 patients could not be classified. Adequate pain relief was reported in less than 25% of patients in both groups. Our study revealed under-prescribing of combination therapy, low utilization rates of strong opioids and prevailing "as needed" prescribing practice. In conclusion, unsatisfactory pain management in medical patients is often present if left solely to the clinical judgement and knowledge of the prescribing physician. Regular pain assessment, evidence-based guidelines, education and regular audits of implementation of these measures are a prerequisite for effective pain treatment, and should all be employed in patients experiencing pain.

Abstract (croatian)

Svrha ovog istraživanja bila je procijeniti kvalitetu liječenja boli u hospitaliziranih internističkih bolesnika. Istraživanje je dizajnirano kao presječno, a uključilo je sve internističke bolesnike hospitalizirane na Internoj klinici Kliničkog bolničkog centra Zagreb koji su trpjeli bol. Od ukupno 167 hospitaliziranih bolesnika na Internoj klinici Kliničkog
bolničkog centra Zagreb, 41 bolesnika koji su naveli da trpe bolove, 40 bolesnika primalo je analgetike. Dvadeset i dva
od 8 bolesnika liječeno je zbog maligne boli, 16 bolesnika zbog nemaligne boli, dok se za 2 bolesnika uzrok boli nije
mogao svrstati u jednu od navedenih skupina. Primjerena kontrola boli zabilježena je u manje od 25% bolesnika u obje
istraživane skupine. Naše je istraživanje ukazalo na nedovoljno propisivanje kombinirane analgetske terapije, nisku
stopu propisivanja jakih opioida te prevladavajuće prepisivanje analgetika »prema potrebi«. Zaključno, liječenje boli u
internističkih bolesnika često je prepušteno samo kliničkoj procjeni i znanju liječnika koji propisuje analgetik. Redovita
procjena boli, smjernice za liječenje boli temeljene na dokazima, edukacija i redovite kontrole provo|enja uvedenih
mjera su pretpostavke za učinkovito liječenje boli, i trebaju biti primijenjeni u svih bolesnika koji trpe bol.

• Keywords (english): Adult; Analgesia/methods; Analgesia/utilization; Analgesics/administration & dosage; Clinical Competence; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pain/drug therapy; Pain/epidemiology; Pain Measurement; Patient Satisfaction; Physicians
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 35, no. 2, pp. 363-368
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:371912
• Publication: 2011-06
• Document URL: https://hrcak.srce.hr/68946
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 19:07:45