Prevalence and treatment of pain in Italian hospitals

Background: Very few studies have been conducted on the presence and control of pain in Italian hospitals. Aims: The present study estimates pain prevalence and therapy in Italian hospitalised patients. Methods: In the autumn of 2000, a survey was taken on 4523 inpatients throughout Italy. All eligible patients were given a questionnaire with two Numerical Rating Scales (NRS) concerning their pain intensity at interview and over the previous 24 h. Nurses were given a second questionnaire asking for information on analgesic treatment and another NRS about the pain they supposed the patient felt. Results: At interview, 91.2% (95%CI: 90.3–92.1%) of the patients reported pain; 46.6% reported severe pain. The prevalence of severe pain was significantly lower in women and was double in general medicine wards compared to surgical wards. The degree of agreement between the pain reported by the patient and the pain scores given by the nurse was poor (Cohen K ¼ 0:318). Only 28.5% of the inpatients had taken analgesics in the past 24 h and the probability of receiving analgesic treatment was higher for women (adjusted OR¼1.33, 95%CI: 1.14–1.54) and lower for general medicine compared to surgical wards (adjusted OR¼0.55, 95%CI: 0.45–0.64), while it was unrelated both to the patient’s self-reported pain and to level of pain assessed by the nurse. Conclusions: Pain affects an impressively high percentage of inpatients and is largely untreated and unrecognised in Italian wards. Educational intervention is required to improve the knowledge and attitudes of health professionals towards the approach and handling of patients in pain.