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Current State of Pain Care for Hospitalized Patients at End of Life
Journal article   Peer reviewed

Current State of Pain Care for Hospitalized Patients at End of Life

Yingwei Yao, Gail Keenan, Fadi Al-Masalha, Karen Dunn Lopez, Ashfaq Khokar, Andrew Johnson, Rashid Ansari and Diana J. Wilkie
American journal of hospice & palliative medicine, Vol.30(2), pp.128-136
03/01/2013
DOI: 10.1177/1049909112444458
PMCID: PMC3681818
PMID: 22556281
url
https://www.ncbi.nlm.nih.gov/pmc/articles/3681818View
Open Access

Abstract

We report findings on the current state of pain care in hospitals for end-of-life (EOL) patients using longitudinal data from eight diverse medical-surgical units located in 4 different Midwestern hospitals over 24 months. We identified 1,425 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.

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