Pain management in a medical walk-in clinic: Link between recommended processes and pain relief

Abstract

Background. While most recommended pain management practices have been developed for hospitalised patients, little is known about their relevance for ambulatory patients presenting with acute pain. Objective. In this study, we explored the relationship between patients' reported use of recommended pain management practices and pain relief in outpatients. Mehtod. 703 adult patients who presented with pain at the medical walk-in clinic of the University Hospitals of Geneva, Switzerland, were included in a mailed cross-sectional survey. They completed a self-administered questionnaire with specific items on self reports of pain and pain management processes. Main outcome measures. Patient's self reports on pain and pain management processes. Results. Of the 703 patients presenting with pain, 40% reported complete pain relief after their visit at the medical walk-in clinic. After adjustment for age, sex, origin, general health and intensity of pain, patients' self-report of complete pain relief was associated with availability of medical doctors (OR = 5.6; 95% CI 2.1-14.7 for excellent vs. poor availability), availability of nurses (OR = 2.6; 95% CI 1.2-6.0 for excellent vs. poor availability), waiting < 10 min for pain medication (OR = 4.6; 95% CI 2.2-9.8), regular assessment of pain (OR = 1.7; 95% CI 1.02-2.7) and having received information about pain and its management (OR = 3.0; 95% CI 1.8-4.9). Conclusions. Self-reported pain relief was associated with more frequent use of recommended pain management processes. These recommendations initially developed for hospitalized patients should also be encouraged for ambulatory care patients. © The Author 2007. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved.