Effectiveness of Pain Management in Hospital in the Home Programs

Abstract

Treatment of pain at home was suboptimal with patients experiencing moderate-to-severe pain and discomfort during the treatment phase of their illness. Lack of appropriate discharge planning strategies meant that patients went home without adequate analgesia and use of nonprescribed pain medication was common. The number of patients transferred home without analgesics indicates a worrying underrecognition of the need for analgesia in this care context and poses a risk to patient safety that is no less significant because patients are at home.

Using the trauma patient experience and evaluation of hospital discharge practices to inform practice change: A mixed methods study

“…Medical records should be extensively reviewed prior to the trauma patient being discharged home to determine if any specific treatments or instructions should be given to the patient, particularly in relation to pain levels and analgesic consumption. Without detailed medical record documentation, clinicians are unlikely to determine the correct analgesic requirements of the patient at hospital discharge (Duke, Botti, & Hunter, ) and insufficient analgesics will consequently be dispensed to the patient when they leave hospital (Terrell et al., ). It is also crucial that analgesic prescribing details at hospital discharge be documented for all trauma patients for clinician reference for outpatient clinics, phone follow‐ups, hospital readmissions and/or other information.…”

Effective pain management in recently discharged adult trauma patients: Identifying patient and system barriers, a prospective exploratory study

“…This finding was also reported in a study of emergency department discharges where approximately one‐fifth of orthopaedic patients were sent home without an analgesic script (Terrell et al., ). Lack of documentation about the in‐hospital pain management of patients suggests that clinicians potentially underestimate effective pain management requirements for these patients at discharge (Duke, Botti, & Hunter, ). Patients without analgesic prescriptions potentially access over‐the‐counter (OTC) pain medications with the increased risk of drug interactions and poly‐pharmacy (Duke et al., ).…”

Human Factors for Dementia: Evidence-Based Design

“…Home care aims to satisfy peoples' health and social needs in their homes by 'providing appropriate and high-quality home-based healthcare and social services, by formal and informal care-givers, with the use of technology when appropriate, within a balanced and affordable continuum of care' [8]. However, the home setting presents challenges for the more established (acute) caregiver-patient interactions and requires adaptation of policies, protocols and routines [9].…”