Pain management policy formulation at a tertiary care teaching institute in India: A prospective observational study.

Abstract

Access to pain management has been recognized as a fundamental human right. Inadequate pain relief hampers the quality of life and has a physiological and psychosocial impact on the patient and caregivers. Inadequate pain relief remains the leading cause of suffering in hospitalized patients worldwide. The objective of this article is to provide adequate pain relief to hospitalized patients through proper assessment, treatment, and monitoring of pain by the trained health-care workers through a sustainable and effective institutional pain management policy. The formulation of pain management policy at a tertiary care teaching institute was conducted in three phases - Phase 1: need assessment by an open-label, uncontrolled, prospective observational study over 1 month period, Phase 2: teaching, training, and awareness of health-care workers, and Phase 3: constitution of the committee at the institute level with the formation of pain resource teams. An open-label, prospective observational study conducted over 1 month revealed that among 814 hospitalized patients, 108 out of 235 (46%) patients in medical and 385 out of 579 (66.5%) patients in the surgical cohort had NRS score of ≥3, implying an inadequate pain relief even at 24 h following medical or surgical intervention, respectively. The provision of effective and adequate pain relief to hospitalized patients requires trained health-care workers and a uniform and structured pain management policy at the institutional level. Recognition and addressal of the barriers and challenges while framing an institutional pain policy is of utmost importance.