Pain assessment and management in medical wards: an area of unmet need.

ABSTRACT

BACKGROUND: Acute Pain Services (APS) were introduced primarily to improve postoperative pain management. Although pain is similar in prevalence and severity in medical and surgical wards, its assessment and management in non-surgical patients often receives less attention and resources. OBJECTIVE: To investigate the extent of APS involvement on medical wards and obtain perceptions of deficiencies. METHOD: A questionnaire was mailed to APS leads in 287 UK NHS hospitals; 229 questionnaires were returned (79.8% response). RESULTS: Only 36 (16%) of the 225 hospitals with medical wards reported routine APS involvement. Pain scores were not recorded in 75 (33%) hospitals, 11 (5%) denied knowledge about assessments being conducted, and 185 (82.2%) respondents felt that pain management on medical wards was inadequate. CONCLUSIONS: Perceived lack of training and awareness of healthcare staff were highly ranked contributing factors, and this was attributed to inadequate funding. This study highlights the scope for improvement of pain control in medical patients, with benefits from reduced morbidity and faster recovery.