Efectividad de la implantación de recomendaciones de una Guía de Buenas Prácticas para manejar el dolor en los pacientes oncológicos hospitalizados

Abstract

Objective

To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) “Assessment and Management of Pain” recommendations for pain control in oncological/oncohaematological hospitalized patients.

Methods

Ambispective cohort study. Sample and Setting: Adults admitted to oncological unit in Hospital of Albacete. Intervention: Implementation of GBP recommendations. Variables: 1) Demographic data; 2) On implementation of GBP recommendations; 3) Outcome in patients: pain intensity in the first 24 h after admission and maximum intensity during admission Tools: Numeric and Visual Scales. Data collection: indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0 = December 2015); initial (T1 = 2017); consolidation (T2 = 2018-2019); sustainability (T3 = 2021-2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: P<.05.

Results

Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%-T0; 98.3%-T1; 98.4%-T2; 91.2%-T3; P<.001), pain assessment using an appropriate scale in 97.6% (558) (0%-T0; 98.3%-T1; 99.2%-T2; 100%-T3; P<.001); 93.7% (535) had a care plan for assessment and management of pain (0%-T0; 98.3%-T1; 96.3%-T2; 92.3%-T3; P<.001). The percentage of patients who had severe pain (6-10) during the first 24 hours was reduced from T1 to T3 (5.1%-T1; 6.6%-T2; 2.1%-T3; P=.145), but throughout hospitalization increased from T1 to T3 (19.2%-T1; 17%-T2; 22.5%-T3; P=.21).

Conclusions

Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.