PAIN IN HOSPITALIZED-PATIENTS WITH AIDS - ANALGESIC AND PSYCHOTROPIC MEDICATIONS

Objective: We undertook this study to evaluate the use of analgesic an d psychotropic medication in acquired immunodeficiency syndrome (AIDS) patients with pain and to determine whether our previous findings of a high prevalence of pain in patients with AIDS who were hospitalized could be replicated. Additional factors related to pain were evaluated , such as death during hospital stay, i.v. drug abuse, and length of h ospital stay. Design: One hundred thirty-nine medical charts randomly selected from 1 year of hospital admissions of patients with AIDS were reviewed in a systematic manner for pain, prescription of analgesic a nd psychotropic medication, patient demographics, and disease characte ristics. Results: Sixty-one percent of the charts reviewed had at leas t one note of nonprocedural pain. Sixty-eight percent of pain patients were prescribed a nonnarcotic (most commonly acetaminophen), and 44% a narcotic. Sixty-two percent of pain patients were prescribed a psych otropic medication. Patients with pain were significantly more likely to receive an analgesic as well as psychotropic medication, particular ly a sedative-hypnotic, than patients without pain. Having pain was no t significantly related to other factors such as i.v. drug abuse excep t for length of hospital stay. Most of the previous study findings wer e replicated with the notable exception of the rate of prescription of psychotropics as well as acetaminophen, which increased substantially in this study. Conclusions: Although pain is a prevalent problem in h ospitalized AIDS patients, narcotics as well as antidepressants appear to be underutilized. It is suggested that medical education regarding pain management in AIDS patients is an important first step in a more aggressive approach.