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4179
Pain Care in Hospitalized Patients: Where are We Missing the Mark?
Session: MP-04b
Thurs, Nov. 16, 3:45-5:15 pm
Saybrook Room

Please note, medically challenging cases are removed three months after the meeting and scientific abstracts after three years.

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Introduction

A heightened interest is being paid to the management of pain in hospitalized patients. Sympathetic activation and cortisol release 1 is increased in the presence of unremitting pain leading to cardiovascular and endocrine complications 2.  Addressing and treating pain has been associated with shorter lengths of stay 3 4 and fewer readmissions 1. We sought to better understand patients’ perception of pain by soliciting feedback surrounding their experience with pain in the hospital.  We aimed to quantify how well prepared patients felt prior to surgery, how effective providers were in addressing pain postoperatively, and how satisfied they were with the pain care they received.  
Material and Methods

Quantitative research was conducted via survey which was sent to 4,521 patients who were hospitalized between March 2015-2017 who indicated their interest in serving on patient panels. Binary, categorical, continuous and aggregate text response data was collected.  

Results

1,054 patients (23.3%) completed the survey.  The population was predominantly female (65%), with most respondents aged 55-74 years old.  47% received in-person education about pain management during their admission while 24% received a pamphlet/brochure. Over one-third (35%) did not receive any information on pain while hospitalized. Of those who received education, 74% indicated it was just the right amount. Patients felt that 60% of nurses and 47% of physicians always addressed their pain care goals. 70% of patients were provided information about managing pain following discharge. 28% never saw any provider to address pain following discharge, though the reason was primarily due to pain being easily resolved at home (31%) or having no pain after a surgery/procedure (29%).

Discussion

 Our study identified longitudinal communication surrounding pain as the primary opportunity to optimize pain care among inpatients.  Interestingly, respondents requested no-cost or low-cost interventions over advanced procedural therapies.  Physician communication surrounding pain, an increased visibility of pain providers and hastier response times were identified as areas for greatest improvement.  Respondents indicated their preference was to receive in-person education about expectations surrounding pain, rather than any other means of communication.  Specifically, patients identified a paucity of education around new medications administered and opioid-associated side effects.  Additionally, they identified the need for a plan to wean from analgesics following discharge. With these data, we intend to tailor our treatment carepath for inpatients to underscore the importance of pain-educational throughout the hospitalization, and reinforce the importance of provider communication.  

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