Effective Pain Management for Inpatients at Siriraj Hospital: A Retrospective Study.

Background and Objective: The prevalence of severe cancer and non-cancer pain among in patients has been reported at rates ranging from 15% to 36%. We examined the effectiveness of the pain management provided to inpatients by the Siriraj Pain Clinic. Material and Method: A retrospective chart review was conducted among inpatients who had consulted the clinic between January 2013 and December 2014. Patients with a numeric pain rating scale (NRS) <4 on the day of consultation, those discharged within seven days, and postoperative patients were excluded. Successful pain control was defined as NRS <4 within seven days of the initial consultation. Results: We identified 352 eligible patients, of which 231 (65.4%) had cancer pain. Only 42.6% achieved successful pain control. An absence of psychological problems (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.1-4.2; p = 0.010); an initial NRS <7 (OR 1.9, 95% CI 1.2-3.0; p = 0.008); the use of either a non-steroidal anti-inflammatory drugs (NSAIDs) or a Coxibs (OR 2.3, 95% CI 1.3-3.9; p = 0.017); and abdominal pain (OR 2.7, 95% CI 1.5-4.7; p = 0.008) were factors associated with successful pain control. Conclusion: Adequate pain control was achieved in less than half of the inpatients in our institution. Psychological disturbance and severe pain predicted unsatisfactory pain control. Keywords: Pain management, Inpatients