The Impact of Pain Assessment on the Hospital Length of Stay of Patients in a Rehabilitation Unit

Study Overview
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Brief Summary
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The financing of the Belgian hospitals is based on a system taking into account the length of hospitalization of a given patient according to his/her pathology, his/her age and his/her geriatric characteristics. This system encourages all hospital to lower the hospitalization duration to the national average for these criteria. This results in better efficiency in the management of hospitalizations but also means a swifter transfer to structures exempted from this system such as revalidation units, nursing homes and psychiatric units. An assessment of the differences in the medical practice, in terms of quality and outcomes of care, is essential for any reform willing to reduce medical costs. Pain management is part of the quality indicators within hospitals. Pain is defined by the International Association for the Study of Pain as an unpleasant sensory and emotional experience, associated to present or potential tissue damage, or described in terms of such a damage. Several studies have showed that pain affects the quality of life and impacts the daily activities. Acute or chronic pain can cause adverse symptoms such as sleep disturbance, appetite loss, decreased concentration, mood changes and the disruption of familial, work and social activities. Pain might also slow down revalidation processes. A study performed by Aprile et al showed that pain negatively influenced the rehabilitation program of a quarter of the patients having had a stroke. The functional recovery was slower and the costs were higher. The aim of this study is to determine if the systematic evaluation of the pain of a patient hospitalized in a revalidation unit has an impact on his/her length of stay.

Official Title
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The Impact of Pain Assessment on the Hospital Length of Stay of Patients in a Rehabilitation Unit

Conditions
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Pain

Intervention / Treatment
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* Other: Pain evaluation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Sequential inclusion of all patients hospitalized in the chronic revalidation hospital unit of the CHU Brugmann - Queen Astrid site Exclusion Criteria: Pathological cognitive state (MMS<23/30)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Daily pain evaluation<br>Patients recruited in a sequential order within the chronic revalidation unit of the CHU Brugmann hospital, Queen Astrid site. | Other: Pain evaluation<br>* Pain will be assessed four times per day on a visual analogic scale.<br>|
| No Intervention: Control<br>Patients recruited in a sequential order within the chronic revalidation unit of the CHU Brugmann hospital, Queen Astrid site. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain score (EVA) | Pain assessment on the Visual Analogic Scale (EVA) | 5 minutes, 4 times per day | 
| Hospitalization duration |  | Hospitalization length (average of 48 days) | 
| HADS score | Hospital Anxiety Depression Scale (questionnaire) | Baseline (first day of hospitalisation) | 
| HADS score | Hospital Anxiety Depression Scale (questionnaire) | Day 30 of hospitalisation | 
| Barthel Index | Daily life activities assessment | Baseline (first day of hospitalisation) | 
| Barthel Index | Daily life activities assessment | Day 30 of hospitalisation | 
| CACS score | Composite score of analgesics consumption | Hospitalization length (average of 48 days) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pain, Hospital length of stay, Revalidation unit