• M P Rockett, G Simpson, R Crossley, and S Blowey.
• Department of Anaesthesia, Critical Care and Pain Medicine, Level 9, Derriford Hospital, Plymouth, UK. mark.rockett@nhs.net
• Br J Anaesth. 2013 Jun 1;110(6):1017-23.

BackgroundThe characteristics and psychological impact of pain suffered by medical inpatients has been relatively under-investigated. The aim of this study was to compare the pain experience of medical, surgical inpatients, and patients attending a pain management centre. Some aspects of the quality of pain scoring and prescribing were also audited.MethodsMedical inpatients with significant pain (moderate or severe pain on a verbal rating scale) were assessed using a battery of psychometric questionnaires. Comparator samples of surgical inpatients and patients attending the pain management centre were recruited.ResultsThe prevalence of significant pain did not differ between the medical group (n=37) and the surgical group (n=38) (16.7% and 19.9%). Chronic pain was common in the medical group (54%) and the surgical group (50%). There were no differences in psychometric variables between the medical and surgical groups. Clinically significant scores for anxiety and depression (HADS ≥11) were common in all groups (30-38%). There was less concordance between patient-reported pain scores and nurse-recorded pain scores in the medical group than the surgical group and analgesic prescribing differed between the two groups.ConclusionsThe characteristics of pain in the medical and surgical groups were similar, with high levels of anxiety and depression. The pain management group differed from the inpatient groups, with higher levels of psychopathology and poorer coping. These findings provide some insight into the complex nature of pain in hospital inpatients, and may inform where limited resources should be utilized to provide greatest patient benefit.

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