Indian Journal of Public Health

LETTER TO EDITOR
Year
: 2022  |  Volume : 66  |  Issue : 3  |  Page : 383-

Factors to consider in the development of institutional pain management policy


G Shankar Ganesh 
 PhD Scholar, Composite Regional Centre for Skill Development, Rehabilitation, and Empowerment of Persons with Disabilities, Lucknow, Uttar Pradesh, India

Correspondence Address:
G Shankar Ganesh
Composite Regional Centre for Skill Development, Rehabilitation, and Empowerment of Persons with Disabilities, Mohan Road, Lucknow - 226 017, Uttar Pradesh
India




How to cite this article:
Ganesh G S. Factors to consider in the development of institutional pain management policy.Indian J Public Health 2022;66:383-383


How to cite this URL:
Ganesh G S. Factors to consider in the development of institutional pain management policy. Indian J Public Health [serial online] 2022 [cited 2022 Dec 2 ];66:383-383
Available from: https://www.ijph.in/text.asp?2022/66/3/383/356619


Full Text



Dear Editor,

In addition to the issues mentioned in the original study[1] published, the implementation of institutional pain management policy development should address the following areas:

The intensity of pain at rest, pain experienced while moving, and the impact of pain on sleep should all be evaluated. Hospitalized patients with poor pain management have been reported to be less active and more susceptible to problems including deep-venous thrombosis and pressure ulcers.[2] In addition to the patient's medical history and level of pain, questions about pain patterns should be asked because some types of pain might cause the patient to experience anxiety, depression, fear, and insomnia as well as interfere with daily activities. The fact that seniors have a lower pain threshold, related medical and cognitive issues, poor reactivity to pharmacologic drugs, atypical symptom presentation, and altered pain perception may all contribute to their greater dissatisfaction with pain management.[3]

Other approaches, such as providing evidence-based guidelines to all staff involved in pain management as a pocket-sized booklet and on electronic platforms in conjunction with staff education, should be taken into consideration in addition to the techniques outlined by the authors of the original study.[1] Continuous evaluation of treatment outcomes and consistent pain reporting ought to be prioritized.

An interprofessional project implementation team may be constituted comprising members with knowledge of pain management and quality improvement, nursing, pharmacy, and physician representatives, as well as therapists, psychologists, pain or palliative care physicians, and representatives from the units and services, where the project is to be implemented. The team will make sure that patients properly inform their health-care provider of their pain that they are educated about, that interventions are provided with minimal waiting time, and that health-care professionals properly follow pain management with their patients.[3]

For a pain intervention to be successful, realistic goals should be set in cooperation with the patient, and patient effort is needed. Oral analgesics with a different mechanism of action should be used in pain interventions, emphasizing nonopioid therapies and increasing the use of nonpharmacological therapies. Intravenous opioids should only be used for acute needs, and patients and medical practitioners should be urged to follow best practices for clinical pain treatment.

Finally, it may be ensured that patients and their caregivers are counseled about how and when to report pain. It is important to make an effort to break down patient barriers including poor communication and the fear of upsetting a doctor with pain concerns. Patients should be made aware that expressing pain during an acute situation is not a bad practice. Patients' perspectives of pain management, including issues with addiction, fear of the negative consequences of pain interventions, the need for additional treatments, associated expenses, and cultural considerations, should be addressed. Another important element in a successful pain treatment program is patient satisfaction with pain management.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Gupta R, Singh R, Ratre BK, Roychoudhury P, Yadav HP, Bhatnagar S. Pain management policy formulation at a tertiary care teaching institute in India: A prospective observational study. Indian J Public Health 2022;66:109-12.
2Available from: https://www.hospitalmedicine.org/globalassets/clinical-topics/clinical-pdf/shm_painmanagement_guide.pdf. [Last accessed on 2022 Jul 16].
3Tawil S, Iskandar K, Salameh P. Pain management in hospitals: Patients' satisfaction and related barriers. Pharm Pract (Granada) 2018;16:1268.