RESUMO
Background: Chronic pain and depression are closely related conditions, which commonly exist as comorbid disorders. Understanding the prevalence of depression in patients presenting with chronic pain is vital for effective pain management. Aim: Our study aimed to establish the prevalence of a history of depression in patients presenting with chronic pain to a chronic pain management clinic at a tertiary academic hospital and to describe the characteristics of patients with both conditions. Setting: Groote Schuur Hospital, Chronic Pain Management Clinic, Cape Town, South Africa. Method: A retrospective review of 665 medical charts of consecutive patients accessing the clinic over a 7-year period was conducted. Baseline, patient-centred data were collected. Results: Of the 665 charts, 623 were analysed. The median age of patients was 53 years. The prevalence of depression in patients presenting with chronic pain was 32%, three times higher than the national life-time prevalence in South Africa. The majority (77%) of patients with chronic pain and depression were female (p < 0.01). Overall, 51% of the patients assessed were unemployed with low levels of education. The majority of our study patients had received a tricyclic antidepressant at some time prior to presentation. Conclusion: The high prevalence of a history of depression in patients presenting with chronic pain in our study, emphasises the importance of looking for and understanding the interrelation of the physiological, psychiatric, psychological and socio-economic factors that are common to both depression and chronic pain. Pain relief alone is insufficient to ensure optimal rehabilitation of these patients and integrating the management of their depression should improve patient outcomes and overall well-being.
RESUMO
BACKGROUND: Pain is the most common presenting complaint in patients visiting a healthcare facility. Healthcare professionals need adequate knowledge of pain to be able to manage it effectively. AIM: The aim of this study was to determine the pain knowledge and attitudes of the 2018 final-year medical students at the University of Cape Town (UCT). SETTING: This study was conducted by the Department of Anaesthesia and Perioperative Medicine in the Faculty of Health Sciences, UCT, South Africa, with final-year medical students. METHODS: Unruh's Modified Pain Knowledge and Attitudes (MPKA) questionnaire was utilised to collect data in a cross-sectional survey using an Internet-based electronic format. RESULTS: A total of 104 students out of 232 students in the class (44.8%) participated in the study. The total median score on the MPKA questionnaire was 46 (interquartile range [IQR] 44-50.5) out of 57, or 80.7% (IQR 77.2-88.6%). The participants performed worst in the section on the pharmacological management of pain with median scores of 6 (IQR 4-8) (55%) correct out of 11 questions. CONCLUSION: Pain knowledge, especially with regard to the pharmacological aspects of pain management, has some important deficiencies in these final-year medical students. It appears that the undergraduate curriculum and teaching thereof would benefit from a review of the pain curriculum.
