A cross-sectional survey of pain in palliative care in Portugal
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ORIGINAL ARTICLE
A cross-sectional survey of pain in palliative care in Portugal Ferraz Gonçalves & Ana Almeida & Catarina Antunes & Maria Cardoso & Margarida Carvalho & Maria Claro & Francisca Coimbra & Inês Diniz & Bruno Fonseca & Emília Fradique & Edna Gonçalves & Florbela Gonçalves & Maria Gonçalves & Américo Magalhães & Paulo Pina & Conceição Pires & Paula Silva & Ricardo Silva & Rui Silva & Filipa Tavares & Laura Teixeira Received: 9 July 2012 / Accepted: 4 February 2013 / Published online: 26 February 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract Objective The purpose of this work is to study the prevalence, intensity, and treatment of pain in Portuguese palliative care teams. Methods Twenty-one palliative care teams were invited to participate in a cross-sectional survey. Ten of these accepted and were included in the study. Data of all patients observed on the 18th week of 2011 were collected. The data collected concerning pain were: demographic data, pain intensity, drugs prescribed, and invasive techniques. The intensity of pain was rated using a five-point verbal rating scale from none to maximum. The Pain Management Index (PMI) was used to calculate the adequacy of the analgesia. Results A total of 164 patients were included in this study. One hundred fifty-one (92 %) had cancer. The median age was 71 years (16 to 95). Eighty-four (51 %) were females. Pain was directly assessed in 136 (83 %) of the patients, whereas 27 patients could not report pain because of
cognitive failure. Of those directly assessed, 77 (57 %) had pain when they were assessed: 42 (55 %) mild, 25 (32 %) moderate, 9 (12 %) severe, and 1 (1 %) maximum. Nonopioid analgesics were used: paracetamol in 61 (37 %) and NSAID in 20 (12 %). Tramadol was the only opioid for mild to moderate pain used in 25 (15 %) patients. The opioids most used for moderate to intense pain were: morphine 74 (45 %), transdermal (TD) fentanyl 32 (20 %), and buprenorphine TD 28 (17 %). The adjuvants most used were: corticosteroids 38 (23 %), gabapentin 37 (23 %), and amitriptyline 15 (9 %). Only five (4 %) patients had a negative PMI, meaning an inadequate analgesia. Conclusion The general prevalence of pain is similar to that reported by other. The prevalence of moderate to severe pain is also similar to that reported in other studies, although severe pain is somewhat lower than indicated in most reports. According to the PMI, pain control was acceptable to good.
F. Gonçalves : A. Almeida : P. Silva Instituto Português de Oncologia, Porto, Portugal
E. Gonçalves : C. Pires Centro Hospitalar de S. João, Porto, Portugal
C. Antunes : I. Diniz Hospital do Mar, Lisbon, Portugal M. Cardoso : R. Silva Centro Hospitalar Lisboa Central, Lisbon, Portugal M. Carvalho : M. Gonçalves Hospital do Litoral Alentejano, Santiago do Cacém, Portugal M. Claro : B. Fonseca Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal F. Coimbra : P. Pina Instituto Português de Oncologia, Lisbon, Portugal E. Fradique : F. Tavares Hospital de St. Maria, Lisbon, Portugal
F. G
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