Current State of Pain Care for Hospitalized Patients at End of Life. (March 2013)

• Record Type: Journal Article
• Authors: Yao, Yingwei; Keenan, Gail; Al-Masalha, Fadi; Lopez, Karen Dunn; Khokar, Ashfaq; Johnson, Andrew; Ansari, Rashid; Wilkie, Diana J.
• Is Part Of: American journal of hospice & palliative care. Volume 30:Number 2(2013)
• Page Start: 128
• Page End: 136
• Publication Date: 2013-03
• Subjects: pain outcomes -- electronic health records -- standardized terminology -- end of life; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909112444458
• Languages: English
• ISSNs: 1049-9091

Abstract

We report findings on the current state of pain care in hospitals for end-of-life (EOL) patients using longitudinal data from 8 diverse medical–surgical units located in 4 different Midwestern hospitals over 24 months. We identified 1425 EOL care episodes, 596 (41.3%) of which had a pain diagnosis. The percentage of EOL patients with pain varied significantly across units ( P < .001) and was even lower (27.7%) for those with "acute confusion." Additionally, 30% of EOL patients had severe or significant pain at death or discharge to hospice and only 42.7% actually met the expected pain-related outcome ratings. Pain often improved within 48 hours of admission ( P < .005), the improvement, however, stagnated following this initial time period ( P = .92). A sizable gap between pain science and clinical practice continues.