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Severe pain at the end of life: a population-level observational study

BACKGROUND: Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significan...

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Autores principales: Hagarty, A. Meaghen, Bush, Shirley H., Talarico, Robert, Lapenskie, Julie, Tanuseputro, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193354/
https://www.ncbi.nlm.nih.gov/pubmed/32354364
http://dx.doi.org/10.1186/s12904-020-00569-2
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author Hagarty, A. Meaghen
Bush, Shirley H.
Talarico, Robert
Lapenskie, Julie
Tanuseputro, Peter
author_facet Hagarty, A. Meaghen
Bush, Shirley H.
Talarico, Robert
Lapenskie, Julie
Tanuseputro, Peter
author_sort Hagarty, A. Meaghen
collection PubMed
description BACKGROUND: Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain. METHODS: Retrospective population-level cohort study of all decedents in Ontario, Canada, from April 1, 2011 to March 31, 2015 who received a home care assessment in the last 30 days of life (n = 20,349). Severe daily pain in the last 30 days of life using linked Ontario health administrative databases. Severe pain is defined using a validated pain scale combining pain frequency and intensity: daily pain of severe intensity. RESULTS: Severe daily pain was reported in 17.2% of 20,349 decedents. Increased risk of severe daily pain was observed in decedents who were female, younger and functionally impaired. Those who were cognitively impaired had a lower risk of reporting pain. Disease trajectory impacted pain; those who died of a terminal illness (i.e. cancer) were more likely to experience pain than those with frailty (odds ratio 1.66). CONCLUSION: Pain is a common fear of those contemplating end of life, but severe pain is reported in less than 1 in 5 of our population in the last month of life. Certain subpopulations may be more likely to report severe pain at the end of life and may benefit from earlier palliative care referral and intervention.
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spelling pubmed-71933542020-05-06 Severe pain at the end of life: a population-level observational study Hagarty, A. Meaghen Bush, Shirley H. Talarico, Robert Lapenskie, Julie Tanuseputro, Peter BMC Palliat Care Research Article BACKGROUND: Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain. METHODS: Retrospective population-level cohort study of all decedents in Ontario, Canada, from April 1, 2011 to March 31, 2015 who received a home care assessment in the last 30 days of life (n = 20,349). Severe daily pain in the last 30 days of life using linked Ontario health administrative databases. Severe pain is defined using a validated pain scale combining pain frequency and intensity: daily pain of severe intensity. RESULTS: Severe daily pain was reported in 17.2% of 20,349 decedents. Increased risk of severe daily pain was observed in decedents who were female, younger and functionally impaired. Those who were cognitively impaired had a lower risk of reporting pain. Disease trajectory impacted pain; those who died of a terminal illness (i.e. cancer) were more likely to experience pain than those with frailty (odds ratio 1.66). CONCLUSION: Pain is a common fear of those contemplating end of life, but severe pain is reported in less than 1 in 5 of our population in the last month of life. Certain subpopulations may be more likely to report severe pain at the end of life and may benefit from earlier palliative care referral and intervention. BioMed Central 2020-04-30 /pmc/articles/PMC7193354/ /pubmed/32354364 http://dx.doi.org/10.1186/s12904-020-00569-2 Text en © The Author(s) 2020 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/. The Creative Commons Public Domain Dedication waiver (http://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 Article
Hagarty, A. Meaghen
Bush, Shirley H.
Talarico, Robert
Lapenskie, Julie
Tanuseputro, Peter
Severe pain at the end of life: a population-level observational study
title Severe pain at the end of life: a population-level observational study
title_full Severe pain at the end of life: a population-level observational study
title_fullStr Severe pain at the end of life: a population-level observational study
title_full_unstemmed Severe pain at the end of life: a population-level observational study
title_short Severe pain at the end of life: a population-level observational study
title_sort severe pain at the end of life: a population-level observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193354/
https://www.ncbi.nlm.nih.gov/pubmed/32354364
http://dx.doi.org/10.1186/s12904-020-00569-2
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