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160 Surprising findings in tracking pain progression in an inpatient cohort who were admitted to a specialist inpatient unit
  1. Abigail Coutinho,
  2. Rachel Whitehorn and
  3. Emer McKenna
  1. Douglas Macmillan Hospice


We aimed to identify whether we are managing our patients pain symptoms effectively using the IPOS as a measuring tool. IPOS forms part of the validated OACC suite of outcomes measures. And also to validate our approach to pain management across all categories and severity of pain and address any deficiencies found. We studied patients over a 3 month period. Interestingly, in the patients with starting higher pain scores 3–4, we found that 53% of patients showed improvements in their pain scores, 38% did not show any improvement and 7% showed worsening. However, in the patient group of starting lower pain scores 1–2 we found that only 12% showed an improvement, while 28% did not show any change and an astonishing 60% showed worsening in their pain scores. Going into this study we were not expecting to find the above result. Reassuring that we are impacting positively for those patients with higher pain scores. However patients with lower pain scores did not appear to have their pain as well controlled. We need to consider possible hypothesis why is this the case. Is it that their AKPS is deteriorating and this is reflected in their pain score? (Total pain theory).Have they fewer distractions at the hospice and is this making their pain worse? Are they witnessing other patients in pain and this is impacting on their impression of their own pain? Are those with higher pain scores getting more attention/time with trained staff and is this having a placebo effect on their pain? At this time we do not have conclusive hypothesis butwe will be undertaking a prospective study following new inpatients that have been identified with low pain scores initially, which has increased on 2nd IPOS. We will be creating a short questionnaire to identify and test our hypothesis.

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