Pain management outcomes varied widely among nearly three dozen inpatient palliative care centers in Korea, according to results of a prospective study published in Cancer.
Researchers collected information on pain control from patient data from the 2009 Korean Terminal Cancer Patient Information System and the records of 34 palliative care centers in the Korean Ministry of Health and Welfare.
The researchers sought to determine if organizational factors influenced pain control. To do that, they measured the self-reported change in pain score and the achievement of pain control at 1 week post-admission in 1,711 patients with terminal cancer.
The average pain score reported by patients at admission was 2.96. The average pain score reported at 1 week was 2.27. This means the centers’ pain management efforts resulted in reductions in pain scores varying from 0.69 to 1.91 at 1 week post-admission. About 30% of patients reported a reduction in pain and 10% reported an increase in pain. About 83% of patients reported achieving adequate pain control.
A higher composite score for human resources adequacy was associated with a greater reduction in pain score and more frequently reported achievement of adequate pain control. Although no one human resource factor was significantly associated with pain control, the presence of volunteers and social workers, as well as a lower nurse case load, were associated with better pain management outcomes.
The presence of these pain management variations is an indication that certain centers need to work toward improving their pain management, the researchers said.
“We believe that more research is needed to identify organizational factors that affect pain management outcomes,” the researchers wrote. “Measures should be taken to reduce organizational factors that are associated within adequate pain management.”