The Impact of Pain Assessment on the Hospital Length of Stay of Patients in a Rehabilitation Unit

Pain Clinical Trial

Official title:

The Impact of Pain Assessment on the Hospital Length of Stay of Patients in a Rehabilitation Unit

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02913833
• Other study ID #: CHUB- EVA-REVA
• Status: Completed
• Phase: N/A
• First received: September 15, 2016
• Last updated: January 18, 2018
• Start date: March 9, 2016
• Est. completion date: December 12, 2017

Study information

• Verified date: January 2018
• Source: Brugmann University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The financing of the Belgian hospitals is based on a system taking into account the length of hospitalization of a given patient according to his/her pathology, his/her age and his/her geriatric characteristics. This system encourages all hospital to lower the hospitalization duration to the national average for these criteria. This results in better efficiency in the management of hospitalizations but also means a swifter transfer to structures exempted from this system such as revalidation units, nursing homes and psychiatric units. An assessment of the differences in the medical practice, in terms of quality and outcomes of care, is essential for any reform willing to reduce medical costs.

Pain management is part of the quality indicators within hospitals. Pain is defined by the International Association for the Study of Pain as "an unpleasant sensory and emotional experience, associated to present or potential tissue damage, or described in terms of such a damage". Several studies have showed that pain affects the quality of life and impacts the daily activities. Acute or chronic pain can cause adverse symptoms such as sleep disturbance, appetite loss, decreased concentration, mood changes and the disruption of familial, work and social activities. Pain might also slow down revalidation processes. A study performed by Aprile et al showed that pain negatively influenced the rehabilitation program of a quarter of the patients having had a stroke. The functional recovery was slower and the costs were higher.

The aim of this study is to determine if the systematic evaluation of the pain of a patient hospitalized in a revalidation unit has an impact on his/her length of stay.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 180
• Est. completion date: December 12, 2017
• Est. primary completion date: December 12, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Sequential inclusion of all patients hospitalized in the chronic revalidation hospital unit of the CHU Brugmann - Queen Astrid site

Exclusion Criteria:

• Pathological cognitive state (MMS<23/30)

Related Conditions & MeSH terms

• Pain

Intervention

Other:
• Pain evaluation
Pain will be assessed four times per day on a visual analogic scale.

Locations

Country	Name	City	State
Belgium	CHU Brugmann	Brussels

Sponsors (1)

Lead Sponsor	Collaborator
Brugmann University Hospital

Country where clinical trial is conducted

Belgium, 

References & Publications (3)

Aprile I, Briani C, Pazzaglia C, Cecchi F, Negrini S, Padua L; Don Carlo Gnocchi Pain-Rehab Group. Pain in stroke patients: characteristics and impact on the rehabilitation treatment. A multicenter cross-sectional study. Eur J Phys Rehabil Med. 2015 Dec;51(6):725-36. Epub 2015 Feb 26. — View Citation

Kreling MC, da Cruz DA, Pimenta CA. [Prevalence of chronic pain in adult workers]. Rev Bras Enferm. 2006 Jul-Aug;59(4):509-13. Portuguese. — View Citation

Schoenthaler M, Miernik A, Offner K, Karcz WK, Hauschke D, Sevcenco S, Kuehhas FE, Bach C, Buchholz N, Wilhelm K. The cumulative analgesic consumption score (CACS): evaluation of a new score to describe postsurgical analgesic consumption as a surrogate parameter for postoperative pain and invasiveness of surgical procedures. Int Braz J Urol. 2014 May-Jun;40(3):330-6. doi: 10.1590/S1677-5538.IBJU.2014.03.06. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Pain score (EVA)	Pain assessment on the Visual Analogic Scale (EVA)	5 minutes, 4 times per day
Primary	Hospitalization duration		Hospitalization length (average of 48 days)
Primary	HADS score	Hospital Anxiety Depression Scale (questionnaire)	Baseline (first day of hospitalisation)
Primary	HADS score	Hospital Anxiety Depression Scale (questionnaire)	Day 30 of hospitalisation
Primary	Barthel Index	Daily life activities assessment	Baseline (first day of hospitalisation)
Primary	Barthel Index	Daily life activities assessment	Day 30 of hospitalisation
Primary	CACS score	Composite score of analgesics consumption	Hospitalization length (average of 48 days)