Assessment of Adequacy and Appropriateness of Pain Management Practice among Traumatic Patients at Addis Ababa Burn, Emergency and Trauma Hospital, Addis Ababa, Ethiopia: A Prospective Observational Study

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Addis Ababa University


Acute pain is the most common and prevalent reason for emergency department (ED) visits with a prevalence of over 70% in the world. The study aimed to assess the adequacy and appropriateness of pain management practice at Aabet Hospital. An observational prospective study was conducted at Aabet hospital from December 1, 2020 to March 30, 2021. Adult traumatic patients having pain (at least score 1 on the Numeric Rating Scale) with a Glasgow Coma Scale score >13 were eligible to participate in the study. The pain intensity was evaluated at the time of admission, at 60, 120, 180, and 240 minutes. The time of first analgesics was registered. The adequacy and the appropriateness of the pain management practice were calculated through the pain management index (PMI) and Pain Medication Appropriateness Scale (PMAS), respectively. Two hundred thirty- two (232) participants were included in this study after obtaining their consent. The majority of the participants 126 (54.3%) were admitted due to road traffic accident followed by falls 44(19%). Only 21 (9.1%) study participants received the first analgesic treatment within 30 minutes while 27(11.6%) participants had no treatment. Among the study participants 72 (31%) received non opioids, 59 (25.6%) received weak opioids, and 37 (15.9%) received strong opioids. Nearly half 110 (47.4%) of the study participants were treated inadequately (PMI (-) score) and nearly two-third (140 (60.3 %)) of the participants were treated inappropriately. The type of analgesia administered, time to analgesia and pain intensity could predict 65% of variance in PMI score (R 2 = 0.65, P= .001). From this study it can be concluded that acute pain in traumatic patients was under and inappropriately treated. Thus, the clinical practitioners should to stay vigilant towards acute pain management in the trauma center.



Pain intensity, time to analgesia, adequacy and appropriateness of pain management, observational study