Prevalence and Correlates of Pain and Pain Treatmentin a Western Kenya Referral Hospital

Abstract

Background:Pain is often inadequately evaluated and treated in sub-Saharan Africa (SSA).Objective:We sought to assess pain levels and pain treatment in 400 hospitalized patients at a national referralhospital in western Kenya, and to identify factors associated with pain and pain treatment.Design:Using face-validated Kiswahili versions of two single-item pain assessment tools, the Numerical RatingScale (NRS) and the Faces Pain Scale–Revised (FPS-R), we determined patients’ pain levels. Additional datacollected included patient demographics, prescribed analgesics, and administered analgesics. We calculatedmean pain ratings and pain management index (PMI) scores.Results:Averaged between the NRS and FPS-R, 80.5% of patients endorsed a nonzero level of pain and 30% ofpatients reported moderate to severe pain. Older patients, patients with HIV, and cancer patients had higherpain ratings. Sixty-six percent of patients had been prescribed analgesics at some point during their hospitali-zation, the majority of which were nonopioids. A majority of patients (66%) had undertreated pain (negativescores on the PMI).Conclusion:This study shows that hospitalized patients in Kenya are experiencing pain and that this pain isoften undertreated