A structured literature review of pain assessment and management of patients with chronic kidney disease

Williams, Allison; Manias, Elizabeth

doi:10.1111/j.1365-2702.2007.01994.x

Cited by 24 publications

(28 citation statements)

References 97 publications

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“…Clearly, the consumers’ experiences demonstrated that prescribers did not want to cause harm to the consumer which affected their pain management. These findings are similar to the limited research into pain management in patients in end stage kidney disease where the prevalence of pain is common and analgesics were underprescribed (Davison 2003, Williams & Manias 2007a). In addition, consumers were hesitant to take analgesic medicines because of their comorbid conditions, a fear of adverse effects and addiction, and pill burden.…”

Section: Discussionsupporting

confidence: 83%

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Perceptions of pain control by consumers with chronic kidney disease

Williams¹,

Manias²

2009

J of Nursing and Healthcare

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Aims and objectives. This study investigated the perceptions of consumers with chronic kidney disease in relation to their pain control, the barriers and enablers to effective pain control, and how they made decisions in relation to their pain control. Background. Consumers with chronic kidney disease are likely to experience pain as a consequence of their kidney disease, comorbidities, treatment and complications which is in need of investigation. Methods. Twenty consumers were recruited from two metropolitan hospitals in Australia in 2007. Structured interviews and medical record review was conducted to gain an understanding of analgesic use and the facilitators and barriers to effective pain control in chronic kidney disease. Results. The consumers’ mean age was 70 years. Consumers had a median of seven chronic health conditions, and multiple sources of acute and chronic pain. Athematic analysis of the interviews revealed five themes, which included the complexity of pain, pain relief approaches, ineffective pain control, limited analgesic options, and health professional factors. Conclusions. Consumers in this study regularly experienced pain that averaged 6·7 on the numerical pain rating scale that was unrelieved with medically recommended analgesic regimens. Chronic pain was harder to control because of its unrelenting nature and the nephrotoxic risk of analgesic medicines. Consumers’ concomitant chronic health problem, interfered with what analgesia the consumers could be prescribed to relieve pain. General Practitioners were most frequently consulted for pain control rather than medical specialists. Consumers were prescribed a median of nine different medicines per day which influenced their approach to pain relief. Relevance to clinical practice. Consumers with chronic kidney disease require guidance to help them to manage their pain effectively. Prescribers concerned about analgesics’ nephrotoxic risk need to carefully consider the consumer’s everyday quality of life when managing pain. Educational strategies to improve consumers’ pain management practices in collaboration with health professionals are warranted.

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Section: Discussionsupporting

confidence: 83%

“…2005). A literature review examining studies of pain control in kidney disease found that the risk of analgesic‐induced morbidity dominated over an interest in pain relief in patients on dialysis, significantly affecting their quality of life (Williams & Manias 2007a).…”

Section: Introductionmentioning

confidence: 99%

Perceptions of pain control by consumers with chronic kidney disease

Williams¹,

Manias²

2009

J of Nursing and Healthcare

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“…There has been recognition that pain is a significant problem in other non-curative conditions such as the human immunodeficiency virus (HIV) (2,3), multiple sclerosis (MS) (4), end stage cardiac disease (5), end stage renal failure (6), and advanced chronic obstructive pulmonary disease (COPD) (7), amongst others. As such, the management of pain within the palliative care field has become a broader issue, and the expertise within the palliative care professionals, much of which has been gained with cancer patients, is now extending into other areas.…”

Section: Introductionmentioning

confidence: 99%

Pharmacological management of pain in palliative care

Black¹

2009

International Journal on Disability and Human Development

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“…Pain in patients with multiple comorbidities contributes to impaired well being, poor physical function, depression, quality of care, and health care overutilization (4)(5)(6)(7)(8). Chronic pain is reported to be prevalent in ESRD (9)(10)(11)(12)(13), but is less commonly studied in predialysis CKD (12,13). The causes of chronic pain across the spectrum of kidney disease are not well understood.…”

Section: Introductionmentioning

confidence: 99%

“…Chronic pain often leads to analgesic use (14), but some of these medications' prescription and dosing require special consideration with impaired renal function (11)(12)(13). Prescription and over-the-counter (OTC) purchase of nonsteroidal anti-inflammatory drugs (NSAIDs) are more common in CKD than desirable because they are considered nephrotoxic (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Chronic Pain and Analgesic Use in CKD

Wu¹,

Ginsberg²,

Zhan

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Chronic pain in predialysis CKD is not fully understood. This study examined chronic pain in CKD and its relationship with analgesic usage.Design, setting, participants, & measurements Data include baseline visits from 308 patients with CKD enrolled between 2011 and 2013 in the Safe Kidney Care cohort study in Baltimore, Maryland. The Wong-Baker FACES Pain Rating Scale measured chronic pain severity. Analgesic prescriptions and over-the-counter purchases were recorded up to 30 days before visits, and were classified as a drug-related problem (DRP) based on an analgesic's nephrotoxicity and dose appropriateness at participants' eGFR. Participants were sorted by pain frequency and severity and categorized into ordinal groups. Analgesic use and the rate of analgesics with a DRP were reported across pain groups. Multivariate regression determined the factors associated with chronic pain and assessed the relationship between chronic pain and analgesic usage.Results There were 187 (60.7%) participants who reported chronic pain. Factors associated with pain severity included arthritis, taking $12 medications, and lower physical function. Use of nonsteroidal anti-inflammatory drugs was reported by seven participants (5.8%) with no chronic pain. Mild and severe chronic pain were associated with analgesics with a DRP, with odds ratios of 3.04 (95% confidence interval [95% CI], 1.12 to 8.29) and 5.46 (95% CI, 1.85 to 16.10), respectively. The adjusted rate of analgesics with a DRP per participant increased from the group with none to severe chronic pain, with rates of 0.07 (95% CI, 0.04 to 0.13), 0.12 (95% CI, 0.07 to 0.20) and 0.16 (95% CI, 0.09 to 0.27), respectively.Conclusions Chronic pain is common in CKD with a significant relationship between the severity of pain and both proper and improper analgesic usage. Screening for chronic pain may help in understanding the role of DRPs in the delivery of safe CKD care.

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A structured literature review of pain assessment and management of patients with chronic kidney disease

Cited by 24 publications

References 97 publications

Perceptions of pain control by consumers with chronic kidney disease

Perceptions of pain control by consumers with chronic kidney disease

Pharmacological management of pain in palliative care

Chronic Pain and Analgesic Use in CKD

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