Pain prevalence in hospitalized patients at a tertiary academic medical center: Exploring severe persistent pain

Wu, Chieh‐Liang; Hung, Yin-Lurn; Wang, Yanru; Huang, Huimei; Chang, Chia‐Hui; Wu, Chih-Cheng; Hung, Chih-Jen; Yeh, Te-Feng

doi:10.1371/journal.pone.0243574

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…Chronic pain affects approximately 20% of children and adults,1 and is one of the most common reasons for healthcare visits 2 3. Further, acute pain is prevalent across most healthcare settings 4 5. Both acute and chronic pain have significant, negative consequences 6 7.…”

Section: Introductionmentioning

confidence: 99%

Dose-dependent effects of high intensity focused ultrasound on compound action potentials in an ex vivo rodent peripheral nerve model: comparison to local anesthetics

Anderson

Delgado

Sun

et al. 2022

Reg Anesth Pain Med

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BackgroundIn animal models, focused ultrasound can reversibly or permanently inhibit nerve conduction, suggesting a potential role in managing pain. We hypothesized focused ultrasound’s effects on action potential parameters may be similar to those of local anesthetics.MethodsIn an ex vivo rat sciatic nerve model, action potential amplitude, area under the curve, latency to 10% peak, latency to 100% peak, rate of rise, and half peak width changes were assessed after separately applying increasing focused ultrasound pressures or concentrations of bupivacaine and ropivacaine. Focused ultrasound’s effects on nerve structure were examined histologically.ResultsIncreasing focused ultrasound pressures decreased action potential amplitude, area under the curve, and rate of rise, increased latency to 10% peak, and did not change latency to 100% peak or half peak width. Increasing local anesthetic concentrations decreased action potential amplitude, area under the curve, and rate of rise and increased latency to 10% peak, latency to 100% peak, and half peak width. At the highest focused ultrasound pressures, nerve architecture was altered compared with controls.DiscussionWhile some action potential parameters were altered comparably by focused ultrasound and local anesthetics, there were small but notable differences. It is not evident if these differences may lead to differences in clinical pain effects when focused ultrasound is applied in vivo or if focused ultrasound pressures that result in clinically relevant changes damage nerve structures. Given the potential advantages of a non-invasive technique for managing pain conditions, further investigation may be warranted in an in vivo pain model.

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Section: Introductionmentioning

confidence: 99%

Dose-dependent effects of high intensity focused ultrasound on compound action potentials in an ex vivo rodent peripheral nerve model: comparison to local anesthetics

Anderson

Delgado

Sun

et al. 2022

Reg Anesth Pain Med

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“…To evaluate the outcome of the hospital-wide pain management project, we surveyed the patients’ pain prevalence from 2018 to 2020 according to a previously published method [ 5 ]. The demographic data of all of the patients are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…We surveyed the pain prevalence of inpatients from 2018 to 2020, according to the method described in our previous research [ 5 ]. We used a questionnaire that is divided into 4 main parts, including (1) personal information, (2) pain experience during hospitalization, (3) perception of pain care from physicians and nurses, and (4) overall satisfaction ( S1 Appendix ).…”

Section: Methodsmentioning

confidence: 99%

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Three-year hospital-wide pain management system implementation at a tertiary medical center: Pain prevalence analysis

Chen

Yeh

et al. 2023

PLoS ONE

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We developed a pain management system over a 3-year period. In this project, “Towards a pain-free hospital”, we combined evidence-based medicine and medical expertise to develop a series of policies. The intervention mainly included the development of standard procedures for inpatient pain management, the implementation of hospital-wide pain medicine education and training, the establishment of a dashboard system to track pain status, and regular audits and feedback. This study aimed to gain an understanding of the changes in the prevalence of pain in inpatients under the care of the pain management system. The subjects of the survey are inpatients over 20 years old, and who had been hospitalized in the general ward for at least 3 days. The patients would be excluded if they were unable to respond to the questions. We randomly selected eligible patients in the general ward. Our trained interviewers visited inpatients to complete the questionnaires designed by our pain care specialists. A total of 3,094 inpatients completed the survey from 2018 to 2020. During the three-year period, the prevalence of pain was 69.5% (2018) (reference), 63.3% (2019) (OR:0.768, p<0.01), and 60.1% (2020) (OR:0.662, p <0.001). The prevalence rates of pain in patients undergoing surgery during the 3-year period were 81.4% (2018), 74.3% (2019), and 68.8% (2020), respectively. As for care-related causes of pain, injection, change in position/chest percussion, and rehabilitation showed a decreasing trend over the 3-year period of study. Our pain management system provided immediate professional pain management, and achieved a good result in the management of acute moderate to severe pain, especially perioperative pain. Studies on pain prevalence and Pain-Free Hospitals are scarce in Asia. With the aid of the policies based on evidence-based medicine and the dashboard information system, from 2018 to 2020, the prevalence of pain has decreased year by year.

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“…Acute pain is an important public health issue; its prevalence is high across multiple health care settings, including inpatient wards, emergency departments, and postoperative units. [1][2][3][4][5][6][7][8] In the United States, up to 75% of patients experience moderate to severe pain after surgery, 66% of patients report moderate to severe pain during emergency visits, and 40% to 80% of adult inpatients experience moderate or severe pain at some point during hospitalization. 1,[3][4][5][6][7]9 In adults, insufficiently controlled acute pain has significant negative consequences across most organ systems and aspects of daily life, including an increased risk of myocardial dysfunction, hyperglycemia, prolonged recovery, developing chronic pain, reduced quality of life, long-term impaired physical function, and increased health care costs.…”

Section: Introductionmentioning

confidence: 99%

Pain Prevalence and Treatment in Hospitalized Children and Adolescents at a US Tertiary Pediatric Hospital

De Souza,

Parvathinathan,

Anderson

2023

Clin Pediatr (Phila)

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Poorly controlled acute pain is associated with worsened patient outcomes. Prior studies suggest that acute pain is a common complaint among hospitalized pediatric patients, but recent studies with substantial numbers of patients from US hospitals are lacking. We retrospectively reviewed inpatients at a single academic children’s hospital during twelve 24-hour periods in 2021. Outcomes were assessed for patients on non–intensive care unit (ICU) inpatient floors and in ICUs. The primary outcome was any presence of moderate to severe pain. Of 1355 patients on a non-ICU inpatient floor and 485 patients in the ICU, 23.5% and 58.6%, respectively, had ≥1 moderate to severe pain score during the 24-hour analysis period. While the mean pain score was low for the majority of patients, moderate to severe pain is frequent in hospitalized children. Future studies may focus on identification of variables associated with pediatric inpatients at risk of moderate to severe pain as well as improved pain prevention and reduction strategies.

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Pain prevalence in hospitalized patients at a tertiary academic medical center: Exploring severe persistent pain

Cited by 14 publications

References 18 publications

Dose-dependent effects of high intensity focused ultrasound on compound action potentials in an ex vivo rodent peripheral nerve model: comparison to local anesthetics

Dose-dependent effects of high intensity focused ultrasound on compound action potentials in an ex vivo rodent peripheral nerve model: comparison to local anesthetics

Three-year hospital-wide pain management system implementation at a tertiary medical center: Pain prevalence analysis

Pain Prevalence and Treatment in Hospitalized Children and Adolescents at a US Tertiary Pediatric Hospital

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