Patient-controlled oral analgesia at acute abdominal pain: A before-and-after intervention study of pain management during hospital stay

Abstract

Aim: To investigate the patient experience of pain management, when patient-controlled oral analgesia was compared with standard care for patients admitted to hospital with acute abdominal pain. The primary outcome measures were pain intensity and patient perception of care.

Background: Pain management of patients admitted to hospital with acute abdominal pain can be insufficient. Patient involvement in health care has been seen to have benefits for patients.

Methods: A before-and-after intervention study was conducted in an emergency department observation unit and a surgical department. Data were collected from a questionnaire (APS-POQ-R-D) with the six subscales: pain severity, perception of care, interference with activity, interference with emotions, side effects and patient-related barriers.

Results: A total of 156 patients were included. During admission the median score (0-10 scale) for the pain intensity and patient perception of care subscale was 4 (p = 0.96) and 8 (p = 0.92), respectively, in both the control and intervention group. On the activity subscale, the median scores were 6 and 5 (p = 0.17); on the emotion subscale, the scores were 5 and 4 (p = 0.31); and on the side effect subscale, the scores were 3 and 4 (p = 0.18) in the control and intervention group, respectively. Overall, the score was 5-8 at one item about being allowed to participate in decisions about pain treatment as much as wanted.

Conclusion: Patient-controlled oral analgesia did not improve patient experience of pain management for patients admitted to hospital with acute abdominal pain.

Keywords: Acute pain; Pain management; Patient involvement; Patient-centered care; Revised American Pain Society Patient Outcome Questionnaire, APS-POQ-R; Self-administered medication.