Severe pain at the end of life: a population-level observational study
Abstract Background Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically si...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12904-020-00569-2 |
| _version_ | 1818212214299951104 |
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| author | A. Meaghen Hagarty Shirley H. Bush Robert Talarico Julie Lapenskie Peter Tanuseputro |
| author_facet | A. Meaghen Hagarty Shirley H. Bush Robert Talarico Julie Lapenskie Peter Tanuseputro |
| author_sort | A. Meaghen Hagarty |
| collection | DOAJ |
| description | Abstract Background Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain. Methods Retrospective population-level cohort study of all decedents in Ontario, Canada, from April 1, 2011 to March 31, 2015 who received a home care assessment in the last 30 days of life (n = 20,349). Severe daily pain in the last 30 days of life using linked Ontario health administrative databases. Severe pain is defined using a validated pain scale combining pain frequency and intensity: daily pain of severe intensity. Results Severe daily pain was reported in 17.2% of 20,349 decedents. Increased risk of severe daily pain was observed in decedents who were female, younger and functionally impaired. Those who were cognitively impaired had a lower risk of reporting pain. Disease trajectory impacted pain; those who died of a terminal illness (i.e. cancer) were more likely to experience pain than those with frailty (odds ratio 1.66). Conclusion Pain is a common fear of those contemplating end of life, but severe pain is reported in less than 1 in 5 of our population in the last month of life. Certain subpopulations may be more likely to report severe pain at the end of life and may benefit from earlier palliative care referral and intervention. |
| first_indexed | 2024-12-12T05:44:50Z |
| format | Article |
| id | doaj.art-52ac2631d15e4e9eadbdf1027444806d |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-12-12T05:44:50Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-52ac2631d15e4e9eadbdf1027444806d2022-12-22T00:35:50ZengBMCBMC Palliative Care1472-684X2020-04-0119111310.1186/s12904-020-00569-2Severe pain at the end of life: a population-level observational studyA. Meaghen Hagarty0Shirley H. Bush1Robert Talarico2Julie Lapenskie3Peter Tanuseputro4Department of Medicine, Division of Palliative Care, University of OttawaDepartment of Medicine, Division of Palliative Care, University of OttawaOttawa Hospital Research InstituteBruyère Research InstituteDepartment of Medicine, Division of Palliative Care, University of OttawaAbstract Background Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain. Methods Retrospective population-level cohort study of all decedents in Ontario, Canada, from April 1, 2011 to March 31, 2015 who received a home care assessment in the last 30 days of life (n = 20,349). Severe daily pain in the last 30 days of life using linked Ontario health administrative databases. Severe pain is defined using a validated pain scale combining pain frequency and intensity: daily pain of severe intensity. Results Severe daily pain was reported in 17.2% of 20,349 decedents. Increased risk of severe daily pain was observed in decedents who were female, younger and functionally impaired. Those who were cognitively impaired had a lower risk of reporting pain. Disease trajectory impacted pain; those who died of a terminal illness (i.e. cancer) were more likely to experience pain than those with frailty (odds ratio 1.66). Conclusion Pain is a common fear of those contemplating end of life, but severe pain is reported in less than 1 in 5 of our population in the last month of life. Certain subpopulations may be more likely to report severe pain at the end of life and may benefit from earlier palliative care referral and intervention.http://link.springer.com/article/10.1186/s12904-020-00569-2PainEnd-of-lifePalliative carePalliative medicinePalliative homecare |
| spellingShingle | A. Meaghen Hagarty Shirley H. Bush Robert Talarico Julie Lapenskie Peter Tanuseputro Severe pain at the end of life: a population-level observational study BMC Palliative Care Pain End-of-life Palliative care Palliative medicine Palliative homecare |
| title | Severe pain at the end of life: a population-level observational study |
| title_full | Severe pain at the end of life: a population-level observational study |
| title_fullStr | Severe pain at the end of life: a population-level observational study |
| title_full_unstemmed | Severe pain at the end of life: a population-level observational study |
| title_short | Severe pain at the end of life: a population-level observational study |
| title_sort | severe pain at the end of life a population level observational study |
| topic | Pain End-of-life Palliative care Palliative medicine Palliative homecare |
| url | http://link.springer.com/article/10.1186/s12904-020-00569-2 |
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