title: Pain relief in medical patients: does clinical judgment and prescribing knowledge suffice?
abstract: The aim of this study was to evaluate the quality of pain management in hospitalised patients. A cross-sectional study design that included all medical patients experiencing pain was used. Out of 167 patients hospitalized at the Department of Medicine at the University Hospital Zagreb, 41 patients were experiencing pain and 40 out of them received analgesics. Twenty-two out of 38 patients were treated for malignant pain, 16 for non-malignant pain, and 2 patients could not be classified. Adequate pain relief was reported in less than 25% of patients in both groups. Our study revealed under-prescribing of combination therapy, low utilization rates of strong opioids and prevailing "as needed" prescribing practice. In conclusion, unsatisfactory pain management in medical patients is often present if left solely to the clinical judgement and knowledge of the prescribing physician. Regular pain assessment, evidence-based guidelines, education and regular audits of implementation of these measures are a prerequisite for effective pain treatment, and should all be employed in patients experiencing pain.
authors.affiliation: University of Zagreb, Zagreb University Hospital Center, Division of Clinical Pharmacology, Department of Medicine, Zagreb, Croatia. verdeljic@gmail.com
authors.forename: Viktorija
authors.initials: V
authors.lastname: Erdeljić
authors.forename: Igor
authors.initials: I
authors.lastname: Francetić
authors.forename: Ksenija
authors.initials: K
authors.lastname: Makar-Ausperger
authors.forename: Robert
authors.initials: R
authors.lastname: Likić
authors.forename: Viola Macolić
authors.initials: VM
authors.lastname: Sarinić
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods / Q000706:statistics & numerical data*; D000700:Analgesics / Q000008:administration & dosage; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology; D010147:Pain Measurement; D017060:Patient Satisfaction; D010820:Physicians
chemical_list: D000700:Analgesics