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Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study

BACKGROUND: In 2016, we performed a one-day investigation to analyze the prevalence of pain, pain intensity, and pain therapy in the Departments of Surgery and Onco-Hematology of the Ospedale Pediatrico Bambino Gesù. To improve the knowledge gap highlighted in the previous study, refresher courses a...

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Autores principales: Marchetti, Giuliano, Vittori, Alessandro, Cascella, Marco, Mascilini, Ilaria, Piga, Simone, Petrucci, Emiliano, Castellano, Aurora, Caruso, Roberta, Francia, Elisa, Stocchi, Francesca, Marinangeli, Franco, Inserra, Alessandro, Picardo, Sergio Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053721/
https://www.ncbi.nlm.nih.gov/pubmed/36978099
http://dx.doi.org/10.1186/s13052-023-01439-2
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author Marchetti, Giuliano
Vittori, Alessandro
Cascella, Marco
Mascilini, Ilaria
Piga, Simone
Petrucci, Emiliano
Castellano, Aurora
Caruso, Roberta
Francia, Elisa
Stocchi, Francesca
Marinangeli, Franco
Inserra, Alessandro
Picardo, Sergio Giuseppe
author_facet Marchetti, Giuliano
Vittori, Alessandro
Cascella, Marco
Mascilini, Ilaria
Piga, Simone
Petrucci, Emiliano
Castellano, Aurora
Caruso, Roberta
Francia, Elisa
Stocchi, Francesca
Marinangeli, Franco
Inserra, Alessandro
Picardo, Sergio Giuseppe
author_sort Marchetti, Giuliano
collection PubMed
description BACKGROUND: In 2016, we performed a one-day investigation to analyze the prevalence of pain, pain intensity, and pain therapy in the Departments of Surgery and Onco-Hematology of the Ospedale Pediatrico Bambino Gesù. To improve the knowledge gap highlighted in the previous study, refresher courses and even personalized audits have been carried out during these years. The purpose of this study is to evaluate if, after 5 years, there have been improvements in the management of pain. METHODS: The study was conducted on 25 January 2020. Pain assessment, pain therapies, pain prevalence and intensity in the preceding 24 h and during the recovery period were recorded. Pain outcomes were compared with previous audit results. RESULTS: Out of the 63 children with at least one documented pain assessment (starting from 100 eligible), 35 (55.4%) experienced pain: 32 children (50.7%) experienced moderate /severe pain while 3 patients (4%) felt mild pain. In the preceding 24 h, 20 patients (31.7%) reported moderate/severe pain while 10 (16%) reported moderate or severe pain during the interview. The average value of the Pain Management Index (PMI) was − 1.3 ± 0.9 with a minimum of -3 and a maximum of 0. 28 patients (87%) undergoing analgesic therapy for moderate/severe pain had a PMI of less than 0 (undertreated pain), while 3 patients (13%) scored value of 0 or higher (adequate pain therapy), 4 patients (12.5%) received multimodal analgesia with opioids and 2 patients (6%) opioids alone. Time-based therapy was prescribed to 20 patients (62.5%), intermittent therapy was prescribed to 7 patients (22%) and 5 patients (15.5%) did not receive any therapy. The prevalence of pain was higher during hospitalization and 24 h before the interview, while at the time of the interview, the proportion was the same. In this audit, the daily prescription modality of the therapy had some improvements (time-based: 62.5% vs. 44%; intermittent: 22%vs 25%; no therapy: 15.5% vs. 31%). CONCLUSION: Pain management in hospitalized children constantly requires special daily attention from health professionals aimed at mitigating the components of intractable pain and resolving those of treatable pain. TRIAL REGISTRATION: : This study is registered with ClinicalTrials.gov, number (NCT04209764), registered 24 December 2019, https://clinicaltrials.gov/ct2/show/NCT04209764?term=NCT04209764&draw=2&rank=1. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-023-01439-2.
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spelling pubmed-100537212023-03-30 Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study Marchetti, Giuliano Vittori, Alessandro Cascella, Marco Mascilini, Ilaria Piga, Simone Petrucci, Emiliano Castellano, Aurora Caruso, Roberta Francia, Elisa Stocchi, Francesca Marinangeli, Franco Inserra, Alessandro Picardo, Sergio Giuseppe Ital J Pediatr Research BACKGROUND: In 2016, we performed a one-day investigation to analyze the prevalence of pain, pain intensity, and pain therapy in the Departments of Surgery and Onco-Hematology of the Ospedale Pediatrico Bambino Gesù. To improve the knowledge gap highlighted in the previous study, refresher courses and even personalized audits have been carried out during these years. The purpose of this study is to evaluate if, after 5 years, there have been improvements in the management of pain. METHODS: The study was conducted on 25 January 2020. Pain assessment, pain therapies, pain prevalence and intensity in the preceding 24 h and during the recovery period were recorded. Pain outcomes were compared with previous audit results. RESULTS: Out of the 63 children with at least one documented pain assessment (starting from 100 eligible), 35 (55.4%) experienced pain: 32 children (50.7%) experienced moderate /severe pain while 3 patients (4%) felt mild pain. In the preceding 24 h, 20 patients (31.7%) reported moderate/severe pain while 10 (16%) reported moderate or severe pain during the interview. The average value of the Pain Management Index (PMI) was − 1.3 ± 0.9 with a minimum of -3 and a maximum of 0. 28 patients (87%) undergoing analgesic therapy for moderate/severe pain had a PMI of less than 0 (undertreated pain), while 3 patients (13%) scored value of 0 or higher (adequate pain therapy), 4 patients (12.5%) received multimodal analgesia with opioids and 2 patients (6%) opioids alone. Time-based therapy was prescribed to 20 patients (62.5%), intermittent therapy was prescribed to 7 patients (22%) and 5 patients (15.5%) did not receive any therapy. The prevalence of pain was higher during hospitalization and 24 h before the interview, while at the time of the interview, the proportion was the same. In this audit, the daily prescription modality of the therapy had some improvements (time-based: 62.5% vs. 44%; intermittent: 22%vs 25%; no therapy: 15.5% vs. 31%). CONCLUSION: Pain management in hospitalized children constantly requires special daily attention from health professionals aimed at mitigating the components of intractable pain and resolving those of treatable pain. TRIAL REGISTRATION: : This study is registered with ClinicalTrials.gov, number (NCT04209764), registered 24 December 2019, https://clinicaltrials.gov/ct2/show/NCT04209764?term=NCT04209764&draw=2&rank=1. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-023-01439-2. BioMed Central 2023-03-29 /pmc/articles/PMC10053721/ /pubmed/36978099 http://dx.doi.org/10.1186/s13052-023-01439-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Marchetti, Giuliano
Vittori, Alessandro
Cascella, Marco
Mascilini, Ilaria
Piga, Simone
Petrucci, Emiliano
Castellano, Aurora
Caruso, Roberta
Francia, Elisa
Stocchi, Francesca
Marinangeli, Franco
Inserra, Alessandro
Picardo, Sergio Giuseppe
Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study
title Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study
title_full Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study
title_fullStr Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study
title_full_unstemmed Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study
title_short Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study
title_sort pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053721/
https://www.ncbi.nlm.nih.gov/pubmed/36978099
http://dx.doi.org/10.1186/s13052-023-01439-2
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