title: The Barriers to High-Quality Inpatient Pain Management: A Qualitative Study.
abstract: The current literature suggests deficiencies in the quality of acute pain management among general medical inpatients. The aim of this qualitative study is to identify potential barriers to high-quality acute pain management among general medical inpatients at an urban academic medical center during a 2-year period. Data are collected using retrospective chart reviews, survey questionnaires, and semistructured, open-ended interviews of 40 general medical inpatients who have experienced pain during their hospitalization. Our results confirm high prevalence and disabling impacts of pain and significant patient- and provider-related barriers to high-quality acute pain management. We also identify unique system-related barriers such as time delay and pain management culture. Efforts to improve the pain management experience of general medical inpatients will need to address all these barriers.
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA ril9016@med.cornell.edu.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Lin
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: M Carrington
authors.initials: MC
authors.lastname: Reid
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Lydia L
authors.initials: LL
authors.lastname: Liu
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Chused
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Arthur T
authors.initials: AT
authors.lastname: Evans
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D012189:Retrospective Studies; D014505:Urban Population; D055815:Young Adult
keywords: acute pain; addiction; general medical inpatients; opioid; pain management; quality improvement
references.citation: Ann Intern Med. 2014 Feb 4;160(3):207
references.pmid: 24322334
references.citation: J Gen Intern Med. 2006 Jun;21(6):607-12
references.pmid: 16808744
references.citation: Support Care Cancer. 2003 Sep;11(9):587-92
references.pmid: 12905055
references.citation: Lancet. 2006 May 13;367(9522):1618-25
references.pmid: 16698416
references.citation: Health Serv Res. 2009 Feb;44(1):245-63
references.pmid: 19146567
references.citation: Health Serv Res. 2009 Feb;44(1):264-87
references.pmid: 19146568
references.citation: Med J Aust. 2003 Jul 21;179(2):84-7
references.pmid: 12864718
references.citation: J Pain Symptom Manage. 2005 May;29(5):498-506
references.pmid: 15904752
references.citation: J Pain Symptom Manage. 2004 Jul;28(1):47-58
references.pmid: 15223084
references.citation: J Pain Symptom Manage. 2003 Jan;25(1):9-18
references.pmid: 12565184
references.citation: Arch Intern Med. 2004 Jan 26;164(2):175-80
references.pmid: 14744841
references.citation: Eur J Cancer. 2009 May;45(8):1370-80
references.pmid: 19201599
references.citation: Ann Intern Med. 1973 Feb;78(2):173-81
references.pmid: 4683747
references.citation: Anesth Analg. 2005 Aug;101(2):474-480
references.pmid: 16037164
references.citation: J Pain Symptom Manage. 2003 Jun;25(6):519-27
references.pmid: 12782432
references.citation: Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):273-6
references.pmid: 20031238
references.citation: J Clin Oncol. 2007 May 1;25(13):1792-801
references.pmid: 17470871
references.citation: J Pain Symptom Manage. 2009 Jun;37(6):1039-49
references.pmid: 19278818
references.citation: J Pain. 2010 Nov;11(11):1172-86
references.pmid: 20400379
references.citation: J R Coll Physicians Edinb. 2009 Dec;39(4):292-5
references.pmid: 21152463
references.citation: Pain Med. 2009 Oct;10(7):1183-99
references.pmid: 19818030
references.citation: Arch Intern Med. 2005 Jul 25;165(14):1574-80
references.pmid: 16043674
references.citation: Eur J Pain. 2005 Oct;9(5):485-95
references.pmid: 16139177
references.citation: Arch Intern Med. 2006 May 8;166(9):1033-9
references.pmid: 16682579