Assessment of acute pain and its management in an urban emergency department in Ghana

TL;DR

This study examines acute pain prevalence and management in an urban Ghanaian emergency department, finding high pain levels and long wait times for treatment.

Contribution

The study provides empirical data on acute pain management in a Ghanaian ED, highlighting delays in treatment and patient satisfaction.

Findings

76% of patients reported severe pain upon arrival at the ED.

Average waiting time for analgesia was 184 minutes, indicating significant delays.

Most patients (75%) expressed maximum satisfaction despite delayed treatment.

Abstract

Acute pain is classified as pain that lasts less than three to six months. Globally, pain is the third most common health problem with more than a quarter of patients reporting to the Emergency Department (ED) with pain-related chief complaints. This study aimed to determine the prevalence of acute pain and assess the pain management practices in the Komfo Anokye Teaching Hospital Emergency Department (KATH ED).

Using the Numeric Rating Scale (NRS), the characteristics of acute pain among 378 patients presenting to KATH ED were measured. Additionally, the waiting time for the first pain treatment was calculated for each patient. Pain scores (pre- and post-treatment) were also taken to further inform patients’ satisfaction.

Out of 378 patients, 76% [95% CI: 71.3–80.2] reported to the ED with severe pain, 21% [95% CI: 16.9–25.4] reported with moderate pain, and 3% [95% CI: 1.5–5.1] reported with mild pain. The average waiting time for the initial assessment of pain was 83.97 minutes while the average waiting time for the administration of analgesia was 184.07 minutes. Having completed primary (AOR, 5.36; 95% CI, 1.03–27.97), JHS (AOR, 5.8; 95% CI, 1.19–28.35), SHS (AOR, 7.24; 95% CI, 1.38–38.01) and tertiary (AOR, 9.42; 95% CI, 1.60–55.62) were predictive of Door‑to‑Analgesia (DTA) time ≤ 90 minutes. Nearly three quarters of the study participants had maximum satisfaction with the pain management services in the ED.

The study revealed that documentation of pain severity scores of patients presenting with acute pain at KATH ED was encouraging, however, most patients did not receive timely pain relief. The average waiting time for the initial assessment of pain as well as the administration of analgesia was extremely prolonged. Despite this, three out of every four of the study participants had maximum satisfaction for the overall pain treatment services in the ED. These findings suggest that pain management practices at KATH ED need improvement.

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