The profile of chronic pain patients attending the Helen Joseph Hospital Pain Management Unit
Date
2014
Authors
Mayat, Yasmin Mohamed Saleem
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND:
Chronic
pain
is
a
biopsychosocial
phenomenon
that
can
have
a
profound
impact
on
people’s
lives.
Internationally,
chronic
pain
is
being
recognised
as
a
health
priority.
South
Africa
is
a
developing
country
with
limited
resources
that
are
directed
at
catering
for
a
growing
population
where
life
threatening
conditions
like
Human
Immunodeficiency
Virus
(HIV)/Acquired
Immunodeficiency
Syndrome
(AIDS),
violent
crimes,
and
poverty
predominate.
Auditing
the
Helen
Joseph
Hospital
Pain
Management
Unit
(HJHPMU)
is
a
step
towards
addressing
the
paucity
of
epidemiological
data
on
chronic
pain
in
South
Africa.
Clinical
records
are
a
basic
clinical
tool
that
also
serves
as
a
medicolegal
document.
It
is
essential
that
these
records
are
legible
and
complete.
AIM:
The
aim
of
this
study
was
to
describe
the
profile
of
chronic
pain
patients
at
the
HJHPMU
for
2011
and
to
determine
the
adequacy
of
record
keeping.
METHODOLOGY:
A
retrospective,
contextual,
descriptive
study
design
was
utilised.
A
consecutive
sampling
method
was
used
and
the
study
sample
included
the
HJHPMU
database
and
all
files
of
adult
patients
that
attended
the
HJHPMU
during
the
period
January
2011
to
December
2011.
Patient
files
were
excluded
from
the
audit
if
insufficient
data
were
found.
Descriptive
statistics
were
used
to
analyse
the
data
obtained
during
the
study.
Frequencies
and
percentages
have
been
reported.
A
Chi-‐squared
test
was
utilised
to
analyse
any
association
between
gender
and
type
of
pain.
RESULTS:
There
were
475
patients
in
the
HJHPMU
database
for
the
year
2011
and
190
of
these
patients
were
excluded
from
the
study
due
to
illegible
handwriting,
duplication
in
the
HJHPMU
database,
missing
data
such
as
no
hospital
number
recorded,
no
initials
to
a
surname,
or
the
file
not
found.
This
resulted
in
a
study
sample
of
285
patients.
The
HJHPMU
had
215
(75,44%)
pre-‐existing
patients
and
70
(24,56%)
new
patients
during
the
year
2011.
The
preponderance
of
patients
were
in
the
41-‐60
year
age
group,
with
146
(51,23%)
patients
presenting
in
this
age
group.
Of
the
285
patients
in
the
study,
91
(31,93%)
patients
were
male
and
194
(68,07%)
were
female.
The
most
common
complaint
was
of
lower
back
pain
(LBP).
There
were
97
(34,04%)
patients
with
a
diagnosis
of
spinal
pain
and
59
(20,70%)
with
Failed
Back
Surgery
Syndrome
(FBSS).
There
were
164
patients
with
a
relevant
surgical
history.
This
included
46
(28,05%)
patients
that
had
been
involved
in
a
traumatic
event,
47
(16,49%)
patients
that
had
surgery
other
than
spinal
surgery
that
was
relevant
to
their
pain
diagnosis,
and
71
patients
(43,29%)
that
4
had
spinal
surgery
that
was
relevant
to
their
diagnosis.
A
Chi-‐squared
test
was
performed
on
the
relationship
between
gender
and
the
type
of
pain,
and
a
p
value
of
0.001
was
found.
When
relating
the
type
of
pain
with
age,
mixed
pain
and
nociceptive
pain
was
found
to
be
most
common
in
those
aged
>60
years
(n=26),
whereas
neuropathic
pain
was
found
to
be
most
common
in
the
41-‐60
year
age
group
(n=43).
CONCLUSION:
With
the
limited
data
from
this
study,
the
profile
of
patients
with
chronic
pain
in
South
Africa
seems
to
not
differ
grossly
from
data
collected
internationally.
The
most
pertinent
finding
of
this
study
is
the
inadequacy
of
record
keeping.
Description
A
research
report
submitted
to
the
Faculty
of
Health
Sciences,
University
of
the
Witwatersrand,
in
partial
fulfillment
of
the
requirements
for
the
degree
of
Master
of
Science
in
Medicine
in
the
branch
of
Anaesthesiology
Johannesburg,
2014