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Impact of admission to hospice on pain intensity and type of pain therapies administered

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Abstract

Purpose

The primary aim of this study was to evaluate pain intensity changes in patients admitted to a hospice. The secondary objective was to evaluate whether these changes in pain were accompanied by modifications in therapies and drugs used to treat pain.

Patients and methods

This retrospective study included 96 patients admitted to a hospice for a minimum of 7 days who received pain therapy. An 11-point (0–10) numerical rating scale (NRS) was used to assess pain on a daily basis. A repeated measures analysis of variance was performed to evaluate pain intensity changes over time.

Results

Mean ± SD pain NRS values of the entire group were 2.58 ± 2.61 on day 1 and 1.40 ± 1.72 on day 7 (P = 0.002). Restricting the analysis to patients with moderate to severe pain at the time of hospice admission, results were even more significant. In fact, mean ± SD pain NRS was 5.51 ± 1.24 for patients with pain ≥4 at admission and 1.76 ± 1.91 for the same patients after 7 days (P < 0.001). A significant increase in the number of patients receiving morphine was observed from day 1 to day 7 (24 to 41, respectively, P = 0.001) and in those receiving drugs via parenteral routes (subcutaneous or intravenous) from 10 to 27 (P = 0.002)

Conclusions

Admission to a hospice and the hospice environment led to a significant reduction in reported pain intensity for the patients included in this study, mainly those with moderate to severe pain at the time of admission. This decrease in pain was accompanied by a significant increase in the use of morphine, especially via parenteral routes, but not by a higher mean equivalent daily dose of oral morphine per patient.

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Acknowledgments

The authors would like to thank Ursula Elbling for editing the article.

Statement of authorship

MM and GC devised the study. MM and SD recruited the patients. LN and SD were responsible for data collection. EP, MM, and ES analysed and interpreted the data. MM and EP drafted the paper. All authors read and approved the final manuscript.

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli, 40, 47014, Meldola, FC, Italy

    Elisabetta Petracci & Emanuela Scarpi

  2. Department of Pharmacy and Biotechnology, University of Bologna, Bologna, BO, Italy

    Letizia Nanni & Gabriele Campana

  3. Palliative Care Unit, Department of Geriatrics, Forlimpopoli Hospital, Forlimpopoli, FC, Italy

    Stefania Derni

  4. Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy

    Marco Maltoni

Authors
  1. Elisabetta Petracci
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  2. Letizia Nanni
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  3. Marco Maltoni
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  4. Stefania Derni
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  5. Gabriele Campana
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  6. Emanuela Scarpi
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Corresponding author

Correspondence to Elisabetta Petracci.

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Petracci, E., Nanni, L., Maltoni, M. et al. Impact of admission to hospice on pain intensity and type of pain therapies administered. Support Care Cancer 24, 225–232 (2016). https://doi.org/10.1007/s00520-015-2768-8

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  • DOI: https://doi.org/10.1007/s00520-015-2768-8

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